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Organization
LYLA BOUSTANI D.D.S. DENTAL CORPORATION
Active
Organization
LYLA BOUSTANI D.D.S. DENTAL CORPORATION
Active
Other names
Dental Specialty Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLA BOUSTANI DDS (PRESIDENT)
(818) 980-0998
Entity
Organization
Contact information
Practice address
12626 RIVERSIDE DR, STE 403, STUDIO CITY, CA 91607-3420
(818) 980-0998
(818) 980-0991
Mailing address
12626 RIVERSIDE DR, STE 403, STUDIO CITY, CA 91607-3420
(818) 980-0998
(818) 980-0991
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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