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Organization

MICHAEL VINCENT LAUREOLA DDS INC

Active
Other names
MAGICLAND DENTAL GROUP OF PACOIMA
Organization subpart
No

Provider details

NPI number
Authorized official
MIGUEL REYES (Q/A CONTRACT & COMPLIANCE MANAGER)
(310) 409-4225
Entity
Organization

Contact information

Practice address
9745 LAUREL CANYON BLVD STE A, ARLETA, CA 91331-4115
(818) 869-5000
(818) 869-7700
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
(310) 820-0408

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
11/08/2019
Last updated
04/02/2026
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