Provider Demographics
NPI:1164138632
Name:FRIDMAN FAMILY DENTAL CARE PC
Entity Type:Organization
Organization Name:FRIDMAN FAMILY DENTAL CARE PC
Other - Org Name:SMILEFUL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-254-3700
Mailing Address - Street 1:27450 TOURNEY RD.
Mailing Address - Street 2:SUITE 70
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:661-254-3700
Mailing Address - Fax:661-254-0709
Practice Address - Street 1:27450 TOURNEY RD.
Practice Address - Street 2:SUITE 70
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-254-3700
Practice Address - Fax:661-254-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental