Provider Demographics
NPI:1174715429
Name:KNORR, EVA NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:NICOLE
Last Name:KNORR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 HOLLYWOOD HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-1443
Mailing Address - Country:US
Mailing Address - Phone:323-691-7589
Mailing Address - Fax:323-656-6130
Practice Address - Street 1:2901 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4536
Practice Address - Country:US
Practice Address - Phone:818-563-9888
Practice Address - Fax:818-563-2888
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48301122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist