Jonathan L Maddatu Dds Inc | |
6736 N. Sepulveda Blvd Van Nuys CA 91411-3306 | |
(818) 786-8803 | |
(818) 786-8570 |
Full Name | Jonathan L Maddatu Dds Inc |
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Speciality | Dentist - General Practice |
Location | 6736 N. Sepulveda Blvd, Van Nuys, California |
Authorized Official Name and Position | Jonathan Lorenzo Maddatu (DENTIST) |
Authorized Official Contact | 8187868803 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Jonathan L Maddatu Dds Inc 6736 N. Sepulveda Blvd Van Nuys CA 91411 Ph: (818) 786-8803 | Jonathan L Maddatu Dds Inc 6736 N. Sepulveda Blvd Van Nuys CA 91411-3306 Ph: (818) 786-8803 |
NPI Number | 1265696173 |
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Provider Enumeration Date | 07/10/2008 |
Last Update Date | 10/22/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265696173 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 55562 (California) | Primary |
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