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General NPI Number Information
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NPI Number | 1508059148
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Entity Type | Organization
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Legal Business Name | NINA FRIDMAN, DDS, INC
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 747 E ALTADENA DR
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City | ALTADENA
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State | CA
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Zip | 91001-2302
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Country | US
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Telephone | 626-794-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 4073 CAMELLIA AVE
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City | STUDIO CITY
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State | CA
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Zip | 91604-3007
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Country | US
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Telephone | 818-505-8895
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | NINA FRIDMAN
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Credential | DDS
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Telephone | 818-505-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 47850
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License Number State | CA
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