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Organization
LISA VALLESTEROS DDS INC
Active
Organization
LISA VALLESTEROS DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA I VALLESTEROS DDS (OWNER DENTIST)
(818) 821-0474
Entity
Organization
Contact information
Practice address
11413 MOORPARK ST, STUDIO CITY, CA 91602-2009
(818) 821-0474
Mailing address
11413 MOORPARK ST, STUDIO CITY, CA 91602-2009
(818) 821-0474
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63351
DENTIST
CA
Enumeration date
03/16/2022
Last updated
03/16/2022
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