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Organization

KIDS COMMUNITY CLINIC OF BURBANK

Active
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Organization

KIDS COMMUNITY CLINIC OF BURBANK

Active
Other names
Kids' Community Dental Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD MARIAS DMD (BOARD PRESIDENT, VOLUNTEER DENTIST)
(818) 841-8010
Entity
Organization

Contact information

Practice address
400 W ELMWOOD AVE, BURBANK, CA 91506-3304
(818) 841-8010
(818) 841-8006
Mailing address
400 W ELMWOOD AVE, BURBANK, CA 91506-3304
(818) 841-8010
(818) 841-8006

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
032653
CA
122300000X
Dentist
Primary
DE33337
CA
124Q00000X
Dental Hygienist
27156
CA
124Q00000X
Dental Hygienist
27544
CA
126800000X
Dental Assistant
77534
CA

Other

Enumeration date
09/24/2014
Last updated
09/24/2014
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