Provider Demographics
NPI:1225233737
Name:NOWRY, REMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:REMOND
Middle Name:
Last Name:NOWRY
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 1:17901 MEDLEY DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4342
Mailing Address - Country:US
Mailing Address - Phone:818-896-0043
Mailing Address - Fax:818-896-0054
Practice Address - Street 1:10059 LAUREL CANYON BLVD
Practice Address - Street 2:STE # A
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-3847
Practice Address - Country:US
Practice Address - Phone:818-896-0043
Practice Address - Fax:818-896-0054
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice