Individual
DR. YONATHAN KOHANBASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
802 US HIGHWAY 491 STE 802, GALLUP, NM 87301-5388
(505) 862-5018
Mailing address
5929 WILBUR AVE, TARZANA, CA 91356-1325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
112365
CA
Other
Enumeration date
09/12/2025
Last updated
09/15/2025
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