Organization
YURY B. GEYLIKMAN, A PROFESSIONAL DENTAL CORPORATION
Active
Other names
Hollywood Braces
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YURY B. GEYLIKMAN DMD, PHD (CEO)
(323) 656-9111
Entity
Organization
Contact information
Practice address
12626 RIVERSIDE DR., #408, VALLEY VILLAGE, CA 91607-3453
(323) 656-9111
Mailing address
12626 RIVERSIDE DR., #408, VALLEY VILLAGE, CA 91607-3453
(323) 656-9111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
41255
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
41255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B41255
MEDI-CAL
CA
Enumeration date
04/09/2007
Last updated
02/09/2016
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