| Maclay Bromont Family Dental Group | |
|
14435 Hamlin St Ste 104 Van Nuys CA 91401-6205 | |
| (818) 898-0004 | |
| (818) 787-0035 |
| Full Name | Maclay Bromont Family Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 14435 Hamlin St Ste 104, Van Nuys, California |
| Authorized Official Name and Position | Abdul Wali Bayaz (PRESIDENT) |
| Authorized Official Contact | 8187810004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maclay Bromont Family Dental Group 14435 Hamlin St Ste 104 Van Nuys CA 91401-6205 Ph: (818) 898-0004 | Maclay Bromont Family Dental Group 14435 Hamlin St Ste 104 Van Nuys CA 91401-6205 Ph: (818) 898-0004 |
| NPI Number | 1639397268 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 04/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639397268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49469 (California) | Primary |
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