Organization
EDALAT DENTAL GROUP, APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMAN EDALAT DDS (PRESIDENT)
(310) 999-9669
Entity
Organization
Contact information
Practice address
18450 DEARBORN ST, NORTHRIDGE, CA 91325-2259
(310) 999-9669
Mailing address
18450 DEARBORN ST, NORTHRIDGE, CA 91325-2259
(310) 999-9669
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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