Individual
DR. YURY GEYLIKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
12626 RIVERSIDE DR.,, 408, VALLEY VILLAGE, CA 91607-3453
(323) 656-9111
(323) 650-9669
Mailing address
12626 RIVERSIDE DR.,, 408, VALLEY VILLAGE, CA 91607-3453
(323) 656-9111
(323) 650-9669
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
05
—
B41255-01
—
CA
05
—
B41255-02
—
CA
05
—
B41255-04
—
CA
Enumeration date
11/27/2006
Last updated
02/09/2016
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