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Organization

GEORGE A MARANON ORAL MAXILLOFACIAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEORGE A. MARANON D.D.S. (OWNER)
(818) 344-0110
Entity
Organization

Contact information

Practice address
18411 CLARK ST, SUITE # 204, TARZANA, CA 91356-3506
(818) 344-0110
(818) 344-0110
Mailing address
18411 CLARK ST, SUITE # 204, TARZANA, CA 91356-3506
(818) 344-0110
(818) 344-0110

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D32127
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D32127
MEDICARE PTAN
CA
Enumeration date
10/08/2008
Last updated
10/08/2008
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