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10149 Reseda Blvd Northridge CA 91324-1454 | |
| (818) 882-3710 | |
| (818) 882-3395 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10149 Reseda Blvd, Northridge, California |
| Authorized Official Name and Position | George Xenakis (OWNER) |
| Authorized Official Contact | 9173745082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10149 Reseda Blvd Northridge CA 91324-1454 Ph: (818) 882-3710 | 10149 Reseda Blvd Northridge CA 91324-1454 Ph: (818) 882-3710 |
| NPI Number | 1376903179 |
|---|---|
| Provider Enumeration Date | 03/07/2016 |
| Last Update Date | 11/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376903179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 64232 (California) | Primary |
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