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General NPI Number Information
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NPI Number | 1952695579
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Entity Type | Organization
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Legal Business Name | SELANE PRODUCTS INC
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 9129 LURLINE AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-5922
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Country | US
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Telephone | 818-998-7460
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Fax | 818-341-4684
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Provider Business Mailing Address
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Address Line | 9129 LURLINE AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-5922
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Country | US
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Telephone | 818-998-7460
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Fax | 818-341-4684
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Authorized Official
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Title or Position | VP OF ACCOUNTING
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Name | MS. WENDY KAYNE
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Credential |
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Telephone | 818-998-7460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number | 13105919
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License Number State | CA
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