Individual
EDWIN JAKOB POULDAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14912 BURBANK BLVD, SHERMAN OAKS, CA 91411-3609
(818) 909-0222
Mailing address
14912 BURBANK BLVD, SHERMAN OAKS, CA 91411-3609
(818) 909-0222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105565
CA
Other
Enumeration date
09/24/2020
Last updated
11/04/2023
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