Konviser Dental Professional Corporation
NPI #1265913081 in Marina Del Rey, California
Provider Information
- NPI Number
- 1265913081
- Entity Type
- Organization
- Organization Name
- Konviser Dental Professional Corporation
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Aug 29, 2018
- Last Updated
- Aug 29, 2018
Practice Location
- Address
- 4644 LINCOLN BLVD STE 404
- City
- Marina Del Rey
- State
- California
- ZIP Code
- 90292-6380
- Phone
- (310) 578-2500
Authorized Official
- Name
- VADIM KONVISER, DDS
- Title
- CEO
- Phone
- (310) 578-2500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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