| Vladimir Vysotsky Dental Corp | |
|
19520 Nordhoff St Suite #17 Northridge CA 91324-2428 | |
| (818) 701-9400 | |
| (818) 701-9083 |
| Full Name | Vladimir Vysotsky Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19520 Nordhoff St, Northridge, California |
| Authorized Official Name and Position | Vladimir Vysotsky (OWNER) |
| Authorized Official Contact | 8187019400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vladimir Vysotsky Dental Corp 19520 Nordhoff St Suite #17 Northridge CA 91324-2428 Ph: (818) 701-9400 | Vladimir Vysotsky Dental Corp 19520 Nordhoff St Suite #17 Northridge CA 91324-2428 Ph: (818) 701-9400 |
| NPI Number | 1518370931 |
|---|---|
| Provider Enumeration Date | 06/03/2014 |
| Last Update Date | 11/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518370931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (California) | Primary |
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