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Organization
LISA KEDERIAN DDS, INC.
Active
Organization
LISA KEDERIAN DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI OTKOSOVA (OFFICE MANAGER)
(424) 901-0701
Entity
Organization
Contact information
Practice address
11500 W OLYMPIC BLVD STE 604, LOS ANGELES, CA 90064-2300
(424) 901-0701
Mailing address
11500 W OLYMPIC BLVD STE 604, LOS ANGELES, CA 90064-2300
(424) 901-0701
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
B54586
CA
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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