Organization
DEREK L VAJDA DDS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK LUDOVIT VAJDA DDS, MD (PRESIDENT)
(219) 789-8308
Entity
Organization
Contact information
Practice address
501 S GARFIELD AVE, ALHAMBRA, CA 91801-3840
(626) 570-1818
Mailing address
1541 CENTINELA AVE, UNIT 105, SANTA MONICA, CA 90404-3222
(219) 789-8308
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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