Modern Smiles Dental Group

NPI #1851661169 in Burbank, California

Provider Information

NPI Number: 1851661169
Entity Type: Organization
Organization Name: Modern Smiles Dental Group
Primary Specialty: Dentist
Enumeration Date: Jan 3, 2012
Last Updated: Feb 24, 2012

Practice Location

Address: 827 N HOLLYWOOD WAY # 213
City: Burbank
State: California
ZIP Code: 91505-2814
Phone: (818) 588-9585

Authorized Official

Name: ANDREW MARTINEZ
Title: OFFICE MANAGER / SECRETARY
Phone: (818) 855-9585

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X
Dentist	122300000X	Primary

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