Healthcare Provider Details

I. General information

NPI: 1588385462
Provider Name (Legal Business Name): ANFRUNS HENDERSON AND KANE DENTAL PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 09/08/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 26TH ST STE 301
SANTA MONICA CA
90402-2567
US

IV. Provider business mailing address

270 26TH ST STE 301
SANTA MONICA CA
90402-2567
US

V. Phone/Fax

Practice location:
  • Phone: 310-394-2796
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: JOAN PI ANFRUNS
Title or Position: PARTNER
Credential: D.M.D
Phone: 917-414-2049