Untalan Dental Corporation

NPI #1245357789 in Pacoima, California

Provider Information

NPI Number: 1245357789
Entity Type: Organization
Organization Name: Untalan Dental Corporation
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 22, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 10750 GLENOAKS BLVD
Address 2: SUITE 6
City: Pacoima
State: California
ZIP Code: 91331-1690
Phone: (818) 686-1400

Authorized Official

Name: DR. CHARISE R UNTALAN II
Title: VP
Phone: (213) 385-3828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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