# DR. J L MADDATU DENTAL CORP.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JONATHAN L. MADDATU DDS INC.
- **Other names:** Jonathan L. Maddatu DDS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790118222
- **Legal business name:** JONATHAN L. MADDATU DDS INC.
- **Authorized official:** DR. JONATHAN LORENZO MADDATU DDS (DENTIST/OWNER)
- **Authorized official phone:** (818) 786-8803

## Contact information

- **Practice address:** 44841 10TH ST W, NONE, LANCASTER, CA 93534-2311
- **Practice address phone:** (661) 948-1655
- **Practice address fax:** (661) 940-9636
- **Mailing address:** 44841 10TH ST W, NONE, LANCASTER, CA 93534-2311
- **Mailing address phone:** (661) 948-1655
- **Mailing address fax:** (661) 940-9636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 55562 | CA | Yes |

## Other

- **Enumeration date:** 08/20/2013
- **Last updated:** 08/20/2013