Individual
DR. BONNIE K. KRYSTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1803 W SUNSET BLVD # 1, LOS ANGELES, CA 90026-3226
(213) 484-9063
Mailing address
PO BOX 1854, CANYON COUNTRY, CA 91386-1854
(213) 484-9063
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39670
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39670
CALIF, DENTAL LIC.
CA
Enumeration date
05/02/2014
Last updated
05/03/2014
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