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Organization
NISMAN & BACQUET, D.D.S., INC.
Active
Organization
NISMAN & BACQUET, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ROBERT BACQUET D.D.S. (C.E.O.)
(818) 841-5654
Entity
Organization
Contact information
Practice address
17214 SATICOY ST, VAN NUYS, CA 91406-2103
(818) 708-9889
Mailing address
17214 SATICOY ST, VAN NUYS, CA 91406-2103
(818) 708-9889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27725
CA
Other
Enumeration date
04/26/2007
Last updated
08/22/2020
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