Provider Demographics
NPI:1457939183
Name:WOODMAN DENTAL CARE
Entity Type:Organization
Organization Name:WOODMAN DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE STAFF
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-437-3676
Mailing Address - Street 1:8725 WOODMAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6562
Mailing Address - Country:US
Mailing Address - Phone:818-891-6670
Mailing Address - Fax:818-893-4439
Practice Address - Street 1:8725 WOODMAN AVE STE B
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6562
Practice Address - Country:US
Practice Address - Phone:818-891-6670
Practice Address - Fax:818-893-4439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty