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General NPI Number Information
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NPI Number | 1730347204
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Entity Type | Individual
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Provider Name | FRANK LAALY DDS, FICOI
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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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 | 310-714-3691
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (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 | 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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