| Magnolia Family Dentistry | |
|
11300 Magnolia Blvd Suite 5 North Hollywood CA 91601-3772 | |
| (818) 980-7222 | |
| (818) 508-1770 |
| Full Name | Magnolia Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11300 Magnolia Blvd, North Hollywood, California |
| Authorized Official Name and Position | Aleksey Fuks (OWNER) |
| Authorized Official Contact | 8189807222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Family Dentistry 11300 Magnolia Blvd Suite 5 North Hollywood CA 91601-3772 Ph: (818) 980-7222 | Magnolia Family Dentistry 11300 Magnolia Blvd Suite 5 North Hollywood CA 91601-3772 Ph: (818) 980-7222 |
| NPI Number | 1720106982 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720106982 | NPI | - | NPPES |
| G89900-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42547 (California) | Primary |
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