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Organization
INNA KAGAN D.D.S. A PROFESSIONAL DENTAL CORPORATION
Active
Organization
INNA KAGAN D.D.S. A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INNA KAGAN D.D.S. (PRESIDENT OF CORPORATION)
(818) 705-0111
Entity
Organization
Contact information
Practice address
17720 SHERMAN WAY, RESEDA, CA 91335-3317
(818) 705-0111
Mailing address
17720 SHERMAN WAY, RESEDA, CA 91335-3317
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43984
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B43984-01
—
CA
Enumeration date
07/31/2006
Last updated
09/14/2012
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