| Omar Eloustaz Dental Corporation | |
|
16633 Ventura Blvd Ste 850 Encino CA 91436-1846 | |
| (818) 990-5900 | |
| Not Available |
| Full Name | Omar Eloustaz Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 16633 Ventura Blvd Ste 850, Encino, California |
| Authorized Official Name and Position | Omar Harbey Eloustaz (CHIEF EXECUTIVE) |
| Authorized Official Contact | 8185793351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omar Eloustaz Dental Corporation 12040 Neenach St Sun Valley CA 91352-3043 Ph: (818) 579-3351 | Omar Eloustaz Dental Corporation 16633 Ventura Blvd Ste 850 Encino CA 91436-1846 Ph: (818) 990-5900 |
| NPI Number | 1356033252 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 10/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356033252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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