| Vanowen Dental Center | |
|
6931 Van Nuys Blvd Ste 100 Van Nuys CA 91405-3937 | |
| (818) 988-8080 | |
| (818) 988-8168 |
| Full Name | Vanowen Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 6931 Van Nuys Blvd Ste 100, Van Nuys, California |
| Authorized Official Name and Position | Yeni Sutanto (BUSINESS PARTNER) |
| Authorized Official Contact | 8189888080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanowen Dental Center 6931 Van Nuys Blvd Ste 100 Van Nuys CA 91405-3937 Ph: (818) 988-8080 | Vanowen Dental Center 6931 Van Nuys Blvd Ste 100 Van Nuys CA 91405-3937 Ph: (818) 988-8080 |
| NPI Number | 1417142050 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 09/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417142050 | NPI | - | NPPES |
| G90871-01 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | B39212 (California) | Primary |
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