Organization
SAM A. LAVI DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRAM ABRAHAM LAVI DMD (PRESIDENT)
(818) 980-8472
Entity
Organization
Contact information
Practice address
4341 LAUREL CANYON BLVD, STUDIO CITY, CA 91604-1710
(818) 980-8472
Mailing address
4341 LAUREL CANYON BLVD, STUDIO CITY, CA 91604-1710
(818) 980-8472
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
41939
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514524
—
CA
Enumeration date
07/05/2007
Last updated
08/22/2020
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