| Su Aldaba Dental Corporation | |
|
19417 7/8 Victory Blvd Reseda CA 91335-6611 | |
| (818) 578-3144 | |
| (818) 578-3197 |
| Full Name | Su Aldaba Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19417 7/8 Victory Blvd, Reseda, California |
| Authorized Official Name and Position | Brittany Su (OWNER DENTIST) |
| Authorized Official Contact | 8185783144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Su Aldaba Dental Corporation 19417 7/8 Victory Blvd Reseda CA 91335-6611 Ph: (818) 578-3144 | Su Aldaba Dental Corporation 19417 7/8 Victory Blvd Reseda CA 91335-6611 Ph: (818) 578-3144 |
| NPI Number | 1972183135 |
|---|---|
| Provider Enumeration Date | 04/12/2021 |
| Last Update Date | 04/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972183135 | NPI | - | NPPES |
| 64911 | Other | CA | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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