# SHAER DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Smile Boutique - Northridge
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740957257
- **Authorized official:** OLGA VERDY (OFFICE MANAGER)
- **Authorized official phone:** (818) 678-9975

## Contact information

- **Practice address:** 8619 RESEDA BLVD STE 101, NORTHRIDGE, CA 91324-4042
- **Practice address phone:** (818) 678-9975
- **Practice address fax:** (818) 812-9383
- **Mailing address:** 8619 RESEDA BLVD STE 101, NORTHRIDGE, CA 91324-4042
- **Mailing address phone:** (818) 678-9975
- **Mailing address fax:** (818) 812-9383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2021
- **Last updated:** 08/24/2021