Vladimir Vysotsky Dental Corp
NPI #1518370931 in Northridge, California
Provider Information
- NPI Number
- 1518370931
- Entity Type
- Organization
- Organization Name
- Vladimir Vysotsky Dental Corp
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 3, 2014
- Last Updated
- Nov 14, 2014
Practice Location
- Address
- 19520 NORDHOFF ST
- Address 2
- SUITE #17
- City
- Northridge
- State
- California
- ZIP Code
- 91324-2428
- Phone
- (818) 701-9400
Authorized Official
- Name
- VLADIMIR VYSOTSKY, DDS
- Title
- OWNER
- Phone
- (818) 701-9400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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