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22800 Lyons Ave Ste 200 Santa Clarita CA 91321-2898 | |
| (661) 254-1884 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 22800 Lyons Ave Ste 200, Santa Clarita, California |
| Authorized Official Name and Position | Sean Kutlay (PRESIDENT) |
| Authorized Official Contact | 6612541884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
22800 Lyons Ave Ste 200 Santa Clarita CA 91321-2898 Ph: (661) 254-1884 | 22800 Lyons Ave Ste 200 Santa Clarita CA 91321-2898 Ph: (661) 254-1884 |
| NPI Number | 1437630340 |
|---|---|
| Provider Enumeration Date | 08/28/2018 |
| Last Update Date | 08/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437630340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 63976 (California) | Primary |
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