Organization
ANATOLY VAISAN DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANATOLY VAISMAN DDS (OWNER/DENTIST)
(818) 365-7191
Entity
Organization
Contact information
Practice address
11273 LAUREL CANYON BLVD, SUITE#3, SAN FERNANDO, CA 91340-4300
(818) 365-7191
(818) 361-7641
Mailing address
11273 LAUREL CANYON BLVD, SUITE#3, SAN FERNANDO, CA 91340-4300
(818) 365-7191
(818) 361-7641
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
88476-48
CA
Other
Enumeration date
01/08/2007
Last updated
10/23/2017
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