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Organization
MACY POUR DDS INC
Active
Organization
MACY POUR DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACY POUR DDS (DENTIST)
(310) 906-8972
Entity
Organization
Contact information
Practice address
5658 SEPULVEDA BLVD STE 204, SHERMAN OAKS, CA 91411-2927
(818) 988-9959
Mailing address
11767 W SUNSET BLVD APT 104, LOS ANGELES, CA 90049-2991
(310) 906-8972
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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