Individual
VIVEK SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, DR.MED.DENT.
Contact information
Practice address
10833 LE CONTE AVE, SUITE AO-156, LOS ANGELES, CA 90095-1668
(310) 825-0834
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 825-0834
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
41040
CA
Other
Enumeration date
03/22/2007
Last updated
01/20/2015
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