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Organization
TIMOTHY LEETRAKUL DDS DENTAL CORPORATION
Active
Organization
TIMOTHY LEETRAKUL DDS DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LEETRAKUL DDS (PRESIDENT)
(818) 765-3534
Entity
Organization
Contact information
Practice address
12643 SHERMAN WAY STE D, NORTH HOLLYWOOD, CA 91605-5271
(818) 765-3534
(818) 765-3537
Mailing address
12643 SHERMAN WAY STE D, NORTH HOLLYWOOD, CA 91605-5271
(818) 765-3534
(818) 765-3537
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
58017
CA
Other
Enumeration date
09/22/2014
Last updated
06/02/2021
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