| Smile Dental | |
|
10920 Venice Blvd Culver City CA 90232-3809 | |
| (310) 204-6661 | |
| (310) 204-6662 |
| Full Name | Smile Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10920 Venice Blvd, Culver City, California |
| Authorized Official Name and Position | Rad Radulovich (DENTIST/OWNER) |
| Authorized Official Contact | 3102046661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Dental 10920 Venice Blvd Culver City CA 90232-3809 Ph: (310) 204-6661 | Smile Dental 10920 Venice Blvd Culver City CA 90232-3809 Ph: (310) 204-6661 |
| NPI Number | 1811196249 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 07/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811196249 | NPI | - | NPPES |
| B44531-01 | Medicaid | CA | |
| 1679643001 | Other | CA | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 44531 (California) | Primary |
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