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Organization
GLENDALE SURGICAL ASSOCIATES, LP
Active
Organization
GLENDALE SURGICAL ASSOCIATES, LP
Active
Parent organization
GLENDALE SURGICAL ASSOCIATES, LP
Other names
Pacific Coast OMS
Organization subpart
Yes
Provider details
NPI number
Legal business name
GLENDALE SURGICAL ASSOCIATES, LP
Authorized official
MS. DIANNE LAFAURIE (OFFICE MANAGER)
(818) 241-4217
Entity
Organization
Contact information
Practice address
23206 LYONS AVE STE 210, NEWHALL, CA 91321-2672
(661) 259-9750
(661) 259-9797
Mailing address
23206 LYONS AVE STE 210, NEWHALL, CA 91321-2672
(661) 259-9750
(661) 259-9797
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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