Organization
ANNA KOLENTSOVA DDS INC
Active
Other names
Serene Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA KOLENTSOVA DDS (PRESIDENT)
(310) 430-2410
Entity
Organization
Contact information
Practice address
12043 MAGNOLIA BLVD, VALLEY VILLAGE, CA 91607-2740
(818) 761-8274
Mailing address
12043 MAGNOLIA BLVD, VALLEY VILLAGE, CA 91607-2740
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407459746
—
CA
Enumeration date
10/22/2024
Last updated
12/12/2024
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