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General NPI Number Information
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NPI Number | 1407194350
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Entity Type | Organization
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Legal Business Name | FRANK LAALY DDS INC
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/06/2024
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Provider Practice Location Address
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Address Line | 19228 VENTURA BLVD STE A
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City | TARZANA
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State | CA
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Zip | 91356-3101
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Country | US
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Telephone | 818-578-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 442 N LA CIENEGA BLVD STE 208
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1934
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Country | US
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Telephone | 323-488-3366
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Fax | 586-261-5802
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Authorized Official
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Title or Position | CEO
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Name | DR. FRANK LAALY
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Credential | DDS, FICOI
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Telephone | 323-488-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 56900
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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