Provider Demographics
NPI:1932329422
Name:ASTRID SOEGAARD D.M.D., INC.
Entity Type:Organization
Organization Name:ASTRID SOEGAARD D.M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:
Authorized Official - Last Name:SOEGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-790-5531
Mailing Address - Street 1:747 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3438
Mailing Address - Country:US
Mailing Address - Phone:818-790-5531
Mailing Address - Fax:818-790-5533
Practice Address - Street 1:747 FOOTHILL BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-3438
Practice Address - Country:US
Practice Address - Phone:818-790-5531
Practice Address - Fax:818-790-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty