| Lisa Vallesteros DDS Inc | |
|
11413 Moorpark St Studio City CA 91602-2009 | |
| (818) 821-0474 | |
| Not Available |
| Full Name | Lisa Vallesteros DDS Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11413 Moorpark St, Studio City, California |
| Authorized Official Name and Position | Lisa I Vallesteros (OWNER DENTIST) |
| Authorized Official Contact | 8188210474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Vallesteros DDS Inc 11413 Moorpark St Studio City CA 91602-2009 Ph: (818) 821-0474 | Lisa Vallesteros DDS Inc 11413 Moorpark St Studio City CA 91602-2009 Ph: (818) 821-0474 |
| NPI Number | 1265180459 |
|---|---|
| Provider Enumeration Date | 03/16/2022 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265180459 | NPI | - | NPPES |
| 63351 | Other | CA | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Secondary |
| 1223G0001X | Dentist - General Practice | () | Primary |
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