Provider Demographics
NPI:1124416987
Name:AMALIA S OSMA DENTAL CORPORATION
Entity Type:Organization
Organization Name:AMALIA S OSMA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-350-3344
Mailing Address - Street 1:1606 BALINESE CT.
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551
Mailing Address - Country:US
Mailing Address - Phone:661-526-3475
Mailing Address - Fax:
Practice Address - Street 1:37935 47TH ST E STE A22
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-3268
Practice Address - Country:US
Practice Address - Phone:661-350-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty