Provider Demographics
NPI:1912594441
Name:LANDA MIZIN DENTAL PARTNERSHIP OF NEWHALL
Entity Type:Organization
Organization Name:LANDA MIZIN DENTAL PARTNERSHIP OF NEWHALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:ANGELES
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-254-0390
Mailing Address - Street 1:23450 LYONS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-5779
Mailing Address - Country:US
Mailing Address - Phone:661-254-0390
Mailing Address - Fax:661-254-2772
Practice Address - Street 1:23450 LYONS AVE STE A
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-5779
Practice Address - Country:US
Practice Address - Phone:661-254-0390
Practice Address - Fax:661-254-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty