| Playa Vista Dental | |
|
12975 Agustin Pl #125 Playa Vista CA 90094-2307 | |
| (213) 453-3407 | |
| Not Available |
| Full Name | Playa Vista Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12975 Agustin Pl, Playa Vista, California |
| Authorized Official Name and Position | Lawrence Fung (OWNER) |
| Authorized Official Contact | 2134533407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Playa Vista Dental 12975 Agustin Pl #125 Playa Vista CA 90094-2307 Ph: (213) 453-3407 | Playa Vista Dental 12975 Agustin Pl #125 Playa Vista CA 90094-2307 Ph: (213) 453-3407 |
| NPI Number | 1013367259 |
|---|---|
| Provider Enumeration Date | 06/19/2016 |
| Last Update Date | 06/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013367259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 60753 (California) | Primary |
Soheil Levi Dds A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6020 Seabluff Dr Ste 5, Playa Vista, CA 90094 Phone: 310-496-6000 |