Provider Demographics
NPI:1447319876
Name:ERSAN, ARTO H (DDS)
Entity type:Individual
Prefix:
First Name:ARTO
Middle Name:H
Last Name:ERSAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8719 WOODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-4729
Mailing Address - Country:US
Mailing Address - Phone:818-830-6181
Mailing Address - Fax:818-920-9294
Practice Address - Street 1:8719 WOODLEY AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-4729
Practice Address - Country:US
Practice Address - Phone:818-830-6181
Practice Address - Fax:818-920-9294
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB-29265021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice