Revadee Tan Veranunt D.D.S.

NPI 1043426976 - Dentist - 122300000X

NPI Details
NPI 1043426976
Gender Female
Enumeration Date 05/15/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
5065 HOLLYWOOD BLVD
#205
LOS ANGELES CA, 90027-6133, US
Phone (323) 666-9881
Fax (323) 666-9881
Business Location
5065 HOLLYWOOD BLVD
#205
LOS ANGELES CA, 90027-6133, US
Phone (323) 666-9881
Fax (323) 666-9881
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 36120
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According to our database, Dr. Revadee Tan Veranunt D.D.S. NPI is 1043426976, taxonomy code is 122300000X and license number is 36120, license state is located at California. Revadee Tan Veranunt D.D.S. physically located at 5065 Hollywood Blvd, Los Angeles CA, 90027-6133. NPI Number Revadee Tan Veranunt D.D.S. has the Individual type.

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1043426976 NPI number is provided on an as is basis without warranty of any kind. 1043426976 is maintained by the National Plan & Provider Enumeration System. The contents of Revadee Tan Veranunt D.D.S. are for informational purposes only.