Organization
LYLA BOUSTANI D.D.S. DENTAL CORPORATION
Active
Other names
Dental Specialty Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLA BOUSTANI DDS (PRESIDENT)
(818) 980-0998
Entity
Organization
Contact information
Practice address
12626 RIVERSIDE DR, STE 403, STUDIO CITY, CA 91607-3420
(818) 980-0998
(818) 980-0991
Mailing address
12626 RIVERSIDE DR, STE 403, STUDIO CITY, CA 91607-3420
(818) 980-0998
(818) 980-0991
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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