Provider Demographics
NPI:1952695579
Name:SELANE PRODUCTS INC
Entity Type:Organization
Organization Name:SELANE PRODUCTS INC
Other - Org Name:SML SPACE MAINTAINERS LABORATORIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF ACCOUNTING
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-998-7460
Mailing Address - Street 1:9129 LURLINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-5922
Mailing Address - Country:US
Mailing Address - Phone:818-998-7460
Mailing Address - Fax:818-341-4684
Practice Address - Street 1:9129 LURLINE AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-5922
Practice Address - Country:US
Practice Address - Phone:818-998-7460
Practice Address - Fax:818-341-4684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13105919292200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory