Provider Demographics
NPI:1821281809
Name:EDWARD E DOVE, DDS PC
Entity Type:Organization
Organization Name:EDWARD E DOVE, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ESSER
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-773-0911
Mailing Address - Street 1:20523 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3208
Mailing Address - Country:US
Mailing Address - Phone:818-773-0911
Mailing Address - Fax:818-773-9720
Practice Address - Street 1:20523 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-3208
Practice Address - Country:US
Practice Address - Phone:818-773-0911
Practice Address - Fax:818-773-9720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51010261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental