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Anatoly Vaisan Dds Inc
Dental Clinic/Center in San Fernando, California
NPI 1023166600

Anatoly Vaisan Dds Inc is a Dental Clinic/Center based in San Fernando, CA and is specialized in Dental. Anatoly Vaisan Dds Inc practices in San Fernando, CA. The NPI Number for Anatoly Vaisan Dds Inc is 1023166600 and holds a License No. 88476-48 (California).

The current practice location address for Anatoly Vaisan Dds Inc is 11273 Laurel Canyon Blvd, San Fernando, CA and can be reached out via phone at 818-365-7191 and via fax at 818-361-7641.

Location: 11273 Laurel Canyon Blvd, San Fernando, CA, 91340-4300
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1023166600
Provider Name
Anatoly Vaisan Dds Inc
Credential
Provider Entity Type
Organization
Address
11273 Laurel Canyon Blvd, San Fernando, CA, 91340-4300
Phone Number
818-365-7191
Fax Number
818-361-7641
Provider Enumeration Date
01/08/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
11273 Laurel Canyon Blvd
City
San Fernando
State
California
Zip
91340-4300
Phone Number
818-365-7191
Fax Number
818-361-7641
person
Provider Business Mailing Address Details
Address
11273 Laurel Canyon Blvd
City
San Fernando
State
California
Zip
91340-4300
Phone Number
818-365-7191
Fax Number
818-361-7641
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
88476-48 (California)
Definition
Definition to come...
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