Organization
WESTCOASTDENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (CREDENTIALING)
(310) 820-9933
Entity
Organization
Contact information
Practice address
15350 NORDHOFF STREET, SUITE A, NORTH HILLS, CA 91351
(818) 672-8228
Mailing address
15350 NORDHOFF STREET, SUITE A, NORTH HILLS, CA 91343
(818) 672-8228
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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