Provider Demographics
NPI:1316261498
Name:NORTH HILLS DENTAL CENTER,INC.
Entity type:Organization
Organization Name:NORTH HILLS DENTAL CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:DJANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-891-0745
Mailing Address - Street 1:15424 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-6951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15424 NORDHOFF ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-6951
Practice Address - Country:US
Practice Address - Phone:818-891-0745
Practice Address - Fax:818-891-6130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA033080261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center