Miro Itskovich D.D.S.

NPI 1407970882 - Dentist - 122300000X

NPI Details
NPI 1407970882
Gender Male
Enumeration Date 03/19/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
5419 NAGLE AVE
SHERMAN OAKS CA, 91401-5341, US
Phone (818) 693-6096
Fax
Business Location
5419 NAGLE AVE
SHERMAN OAKS CA, 91401-5341, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 54541
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According to our database, Dr. Miro Itskovich D.D.S. NPI is 1407970882, taxonomy code is 122300000X and license number is 54541, license state is located at California. Miro Itskovich D.D.S. physically located at 5419 Nagle Ave, Sherman Oaks CA, 91401-5341. NPI Number Miro Itskovich D.D.S. has the Individual type.

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1407970882 NPI number is provided on an as is basis without warranty of any kind. 1407970882 is maintained by the National Plan & Provider Enumeration System. The contents of Miro Itskovich D.D.S. are for informational purposes only.