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Organization
VIVIAN C. BANARIA, DMD, INC.
Active
Organization
VIVIAN C. BANARIA, DMD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVIAN BANARIA DMD (PRESIDENT)
(323) 957-9227
Entity
Organization
Contact information
Practice address
5300 SANTA MONICA BLVD, STE. 401, LOS ANGELES, CA 90029-1131
(323) 957-9227
Mailing address
5300 SANTA MONICA BLVD, STE. 401, LOS ANGELES, CA 90029-1131
(323) 957-9227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
56586
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56586
CA DENTAL BOARD LICENSE
CA
Enumeration date
04/18/2013
Last updated
04/18/2013
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