Individual
DR. DEREK L VAJDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
1541 CENTINELA AVE APT 105, SANTA MONICA, CA 90404-3222
(219) 789-8308
Mailing address
1541 CENTINELA AVE APT 105, SANTA MONICA, CA 90404-3222
(219) 789-8308
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
65363
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DD5450
NM
Other
Enumeration date
05/31/2016
Last updated
07/09/2021
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