Individual
DYLAN BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
601 VERNON AVE, VENICE, CA 90291
(925) 786-1221
Mailing address
4045 VIA MARINA # L310, MARINA DEL REY, CA 90292-6247
(925) 786-1221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101586
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/05/2017
Last updated
05/13/2018
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