# MID VALLEY DENTAL CARE-NORTHRIDGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MID-VALLEY DENTAL CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942490602
- **Authorized official:** DR. TERENCE KIEN-WA LAU D.D.S (OWNER / PARTNER)
- **Authorized official phone:** (818) 886-3500

## Contact information

- **Practice address:** 19331 BUSINESS CENTER DRIVE, SUITE 101, NORTHRIDGE, CA 91324
- **Practice address phone:** (818) 886-3500
- **Practice address fax:** (818) 886-1733
- **Mailing address:** 19331 BUSINESS CENTER DRIVE, SUITE 101, NORTHRIDGE, CA 91324
- **Mailing address phone:** (818) 886-3500
- **Mailing address fax:** (818) 886-1733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/30/2007
- **Last updated:** 08/21/2024