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Nicole Mahanian, D.d.s., Inc.
Dental Clinic/Center in San Fernando, California
NPI 1063025815

Nicole Mahanian, D.d.s., Inc. is a Dental Clinic/Center based in San Fernando, CA and is specialized in Dental. Nicole Mahanian, D.d.s., Inc. practices in San Fernando, CA. The NPI Number for Nicole Mahanian, D.d.s., Inc. is 1063025815 and holds a License No. (California).

The current practice location address for Nicole Mahanian, D.d.s., Inc. is 608 N Maclay Ave, San Fernando, CA and can be reached out via phone at 310-486-4772.

Location: 608 N Maclay Ave, San Fernando, CA, 91340-2137
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1063025815
Provider Name
Nicole Mahanian, D.d.s., Inc.
Credential
Provider Entity Type
Organization
Address
608 N Maclay Ave, San Fernando, CA, 91340-2137
Phone Number
310-486-4772
Fax Number
Provider Enumeration Date
08/30/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104370972 01 CA NPI TYPE 1
institution
Provider Business Practice Location Address Details
Address
608 N Maclay Ave
City
San Fernando
State
California
Zip
91340-2137
Phone Number
310-486-4772
Fax Number
person
Provider Business Mailing Address Details
Address
608 N Maclay Ave
City
San Fernando
State
California
Zip
91340-2137
Phone Number
310-486-4772
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
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Definition
Definition to come...
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