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Organization
SUSANNA GUKASOV DDS PROFESSIONAL CORPORATION
Active
Organization
SUSANNA GUKASOV DDS PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNA GUKASOV DDS (DENTIST)
(323) 369-2493
Entity
Organization
Contact information
Practice address
19520 NORDHOFF ST STE 17, NORTHRIDGE, CA 91324-2444
(818) 701-9400
Mailing address
18746 MAPLEWOOD LN, PORTER RANCH, CA 91326-3927
(323) 369-2493
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2023
Last updated
01/12/2024
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