Overview
No Referral Sources
No Referral Destinations
Practice Locations 1 Prescriptions Same Address Same Phone
No Medical Groups
No Affl. Hospitals
profile image
Primary Practice Address
12724 SHERMAN WAY
NORTH HOLLYWOOD, CA 91605-5031 US

Jiravat Wangwongvivat

Dentist


Jiravat Wangwongvivat

Overview

Jiravat Wangwongvivat is a Dentist in the NORTH HOLLYWOOD area. Jiravat Wangwongvivat primary office location is at 12724 SHERMAN WAY and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1205853157 and the information was updated approximately 17 years ago.

We have not detected any Exclusions tied directly to this NPI.

Accepts Medicare Assignment: Unknown

Is sole proprietor: NO

Participates in PECOS: NO

Contact Information

Primary Practice Location Information
12724 SHERMAN WAY
NORTH HOLLYWOOD, CA 91605-5031 US
Phone: (818)-765-8280
Fax:
Practice Mailing Information
12724 SHERMAN WAY
NORTH HOLLYWOOD, CA 91605-5031 US
Phone: (818)-765-8280
Fax: (818)-765-8454
License NumberState
40201CA
Type/IssuerIdentifierState
DENTI-CALB40201CA
DELTA DENTAL240201CA
TaxonomyStatePrimary?
Dentist - Taxonomy Code 122300000X CAY