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Organization
MAXILLOFACIAL SURGICAL ARTS
Active
Organization
MAXILLOFACIAL SURGICAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT RELLE D.D.S. (PARTNER)
(818) 993-5700
Entity
Organization
Contact information
Practice address
9066 TAMPA AVE, NORTHRIDGE, CA 91324-3523
(818) 993-5700
Mailing address
9066 TAMPA AVE, NORTHRIDGE, CA 91324-3523
(818) 993-5700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
034203
CA
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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