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11966 Ventura Blvd Studio City CA 91604-2606 | |
| (818) 641-5577 | |
| (818) 245-9339 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11966 Ventura Blvd, Studio City, California |
| Authorized Official Name and Position | Jose-luis Ruiz (OWNER) |
| Authorized Official Contact | 8185584332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11966 Ventura Blvd Studio City CA 91604-2606 Ph: (818) 641-5577 | 11966 Ventura Blvd Studio City CA 91604-2606 Ph: (818) 641-5577 |
| NPI Number | 1992168959 |
|---|---|
| Provider Enumeration Date | 03/29/2016 |
| Last Update Date | 03/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992168959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 38124 (California) | Primary |
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