Provider Demographics
NPI:1053490391
Name:MULAS, ANDREA (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MULAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 SUNSET BLVD
Mailing Address - Street 2:SUITE 518
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90089
Mailing Address - Country:US
Mailing Address - Phone:310-246-0995
Mailing Address - Fax:360-246-0956
Practice Address - Street 1:9201 SUNSET BLVD
Practice Address - Street 2:SUITE 518
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90089
Practice Address - Country:US
Practice Address - Phone:310-246-0995
Practice Address - Fax:360-246-0956
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47134122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist