| Pavel Niss Dental Corporation | |
|
9050 Sepulveda Blvd North Hills CA 91343-4308 | |
| (323) 683-2668 | |
| Not Available |
| Full Name | Pavel Niss Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 9050 Sepulveda Blvd, North Hills, California |
| Authorized Official Name and Position | Pavel Niss (PRESIDENT) |
| Authorized Official Contact | 3236832668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pavel Niss Dental Corporation 6331 Rhea Ave Tarzana CA 91335-6834 Ph: (323) 683-2668 | Pavel Niss Dental Corporation 9050 Sepulveda Blvd North Hills CA 91343-4308 Ph: (323) 683-2668 |
| NPI Number | 1053886044 |
|---|---|
| Provider Enumeration Date | 10/05/2018 |
| Last Update Date | 10/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053886044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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