Provider Demographics
NPI:1104940998
Name:STOLYAR, GALINA (DDS)
Entity type:Individual
Prefix:
First Name:GALINA
Middle Name:
Last Name:STOLYAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11755 VICTORY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3423
Mailing Address - Country:US
Mailing Address - Phone:818-761-0010
Mailing Address - Fax:818-761-0012
Practice Address - Street 1:11755 VICTORY BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3423
Practice Address - Country:US
Practice Address - Phone:818-761-0010
Practice Address - Fax:818-761-0012
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist