Healthcare Provider Details
I. General information
NPI: 1205325354
Provider Name (Legal Business Name): NARBEH BANDARY, DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2018
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 N VERDUGO RD STE 207
GLENDALE CA
91208-1258
US
IV. Provider business mailing address
3600 N VERDUGO RD STE 207
GLENDALE CA
91208-1258
US
V. Phone/Fax
- Phone: 818-664-4161
- Fax:
- Phone: 818-664-4161
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | 64631 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
NARBEH
BANDARY
Title or Position: PRESIDENT
Credential: DDS
Phone: 818-664-4161