| Sam A. Lavi Dmd Inc | |
|
4341 Laurel Canyon Blvd Studio City CA 91604-1710 | |
| (818) 980-8472 | |
| Not Available |
| Full Name | Sam A. Lavi Dmd Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4341 Laurel Canyon Blvd, Studio City, California |
| Authorized Official Name and Position | Shahram Abraham Lavi (PRESIDENT) |
| Authorized Official Contact | 8189808472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sam A. Lavi Dmd Inc 4341 Laurel Canyon Blvd Studio City CA 91604-1710 Ph: (818) 980-8472 | Sam A. Lavi Dmd Inc 4341 Laurel Canyon Blvd Studio City CA 91604-1710 Ph: (818) 980-8472 |
| NPI Number | 1659579142 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659579142 | NPI | - | NPPES |
| 514524 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 41939 (California) | Primary |
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