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Organization
MADDATU DENTAL CORPORATION
Active
Organization
MADDATU DENTAL CORPORATION
Active
Other names
Titus Dental Office
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN L MADDATU DDS (DENTIST/ OWNER)
(818) 785-4282
Entity
Organization
Contact information
Practice address
14547 TITUS ST STE 207, PANORAMA CITY, CA 91402-4932
(818) 785-4282
(818) 785-8704
Mailing address
14547 TITUS ST STE 207, PANORAMA CITY, CA 91402-4932
(818) 785-4282
(818) 785-8704
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
55562
CA
Other
Enumeration date
02/10/2015
Last updated
05/30/2015
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