| Timothy Leetrakul Dds Dental Corporation | |
|
12643 Sherman Way Ste D North Hollywood CA 91605-5271 | |
| (818) 765-3534 | |
| (818) 765-3537 |
| Full Name | Timothy Leetrakul Dds Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12643 Sherman Way Ste D, North Hollywood, California |
| Authorized Official Name and Position | Timothy Leetrakul (PRESIDENT) |
| Authorized Official Contact | 8187653534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Leetrakul Dds Dental Corporation 12643 Sherman Way Ste D North Hollywood CA 91605-5271 Ph: (818) 765-3534 | Timothy Leetrakul Dds Dental Corporation 12643 Sherman Way Ste D North Hollywood CA 91605-5271 Ph: (818) 765-3534 |
| NPI Number | 1699177642 |
|---|---|
| Provider Enumeration Date | 09/22/2014 |
| Last Update Date | 06/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699177642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 58017 (California) | Primary |
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