Provider Demographics
NPI:1699055012
Name:COMFORT DENTAL THOUSAND OAKS, PLLC
Entity type:Organization
Organization Name:COMFORT DENTAL THOUSAND OAKS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCITERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-497-6700
Mailing Address - Street 1:3023 THOUSAND OAKS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3556
Mailing Address - Country:US
Mailing Address - Phone:210-497-6700
Mailing Address - Fax:
Practice Address - Street 1:3023 THOUSAND OAKS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3556
Practice Address - Country:US
Practice Address - Phone:210-497-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty