Organization
COURTNEY RAY MITTELMARK, D.M.D., M.S.D., A PROFESSIONAL CORP.
Active
Other names
Playa Vista Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
FABIOLA ORTEGA-FRASCH (MANAGER)
(310) 216-0101
Entity
Organization
Contact information
Practice address
8540 S SEPULVEDA BLVD, #700, LOS ANGELES, CA 90045-3807
(310) 216-0101
(310) 216-1279
Mailing address
8540 S SEPULVEDA BLVD, #700, LOS ANGELES, CA 90045-3807
(310) 216-0101
(310) 216-1279
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
61908
CA
Other
Enumeration date
12/22/2008
Last updated
01/25/2016
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