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General NPI Number Information
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NPI Number | 1649374083
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Entity Type | Individual
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Provider Name | ROMAN KNITER DDS
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16861 VENTURA BLVD SUITE 302
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City | ENCINO
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State | CA
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Zip | 91436-1708
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Country | US
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Telephone | 818-986-8060
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Fax | 818-986-8066
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Provider Business Mailing Address
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Address Line | 3156 DONA MARTA DR
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City | STUDIO CITY
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State | CA
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Zip | 91604-4326
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39430
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License Number State | CA
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