Organization
BRUCE VAFA DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE VAFA D.D.S (PRESIDENT)
(818) 761-3230
Entity
Organization
Contact information
Practice address
4341 LAUREL CANYON BLVD, STUDIO CITY, CA 91604-1710
(818) 761-3230
Mailing address
4341 LAUREL CANYON BLVD, STUDIO CITY, CA 91604-1710
(818) 761-3230
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
52126
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93576-01
DENTICAL
CA
Enumeration date
08/21/2007
Last updated
04/09/2015
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