Most Relevant Information
Provider Data
| NPI Number: | 1003235169 |
| Provider Name: | LUIZA PORTNOFF D.D.S |
| Entity Type: | Individual |
| Taxonomy Code: | 1223S0112X |
| Specialty: | Dentist |
| License Number: | 63572 |
Most Important Dates
| Enumeration Date: | 04/15/2014 |
| Last Updated: | 04/24/2019 |
Provider Practice Location
44439 17TH ST W
LANCASTER
CA
935342831
Practice Location Phone/Fax
| Phone: | 6619454040 |
| Fax: |
Provider Mailing Location
44439 17TH ST W
LANCASTER
CA
935342831
Provider Mailing Phone/Fax
| Phone: | 6619454040 |
| Fax: |