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Organization
JONATHAN L MADDATU DDS INC
Active
Organization
JONATHAN L MADDATU DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LORENZO MADDATU DDS (DENTIST)
(818) 786-8803
Entity
Organization
Contact information
Practice address
6736 N. SEPULVEDA BLVD, VAN NUYS, CA 91411-3306
(818) 786-8803
(818) 786-8570
Mailing address
6736 N. SEPULVEDA BLVD, VAN NUYS, CA 91411
(818) 786-8803
(818) 786-8570
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
55562
CA
Other
Enumeration date
07/10/2008
Last updated
10/22/2009
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