Individual
EDWARD VLADIMIR ALLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11812 GATEWAY BLVD APT 2, LOS ANGELES, CA 90064-2749
(310) 447-8836
Mailing address
11812 GATEWAY BLVD APT 2, LOS ANGELES, CA 90064-2749
(310) 447-8836
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
107276
CA
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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