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Organization
SAM A. LAVI DMD INC
Active
Organization
SAM A. LAVI DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRAM ABRAHAM LAVI DMD (PRESIDENT)
(818) 980-8472
Entity
Organization
Contact information
Practice address
4341 LAUREL CANYON BLVD, STUDIO CITY, CA 91604-1710
(818) 980-8472
Mailing address
4341 LAUREL CANYON BLVD, STUDIO CITY, CA 91604-1710
(818) 980-8472
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
41939
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514524
—
CA
Enumeration date
07/05/2007
Last updated
08/22/2020
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