Provider Demographics
NPI:1629475751
Name:LEONARD NAFTALIN DDS A DENTAL CORPORATION
Entity Type:Organization
Organization Name:LEONARD NAFTALIN DDS A DENTAL CORPORATION
Other - Org Name:COMFORT DENTAL ANESTHESIA GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:NAFTALIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-795-5027
Mailing Address - Street 1:8055 W MANCHESTER AVE
Mailing Address - Street 2:204
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7960
Mailing Address - Country:US
Mailing Address - Phone:310-795-5027
Mailing Address - Fax:
Practice Address - Street 1:6323 ESPLANADE
Practice Address - Street 2:
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7581
Practice Address - Country:US
Practice Address - Phone:310-795-5027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDentist AnesthesiologistGroup - Single Specialty