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General NPI Number Information
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NPI Number | 1063632669
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Entity Type | Organization
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Legal Business Name | HOUTAN HOSSEINI DENTAL CORPORATION
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 2016 E ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-4223
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Country | US
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Telephone | 661-324-1000
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Fax | 661-324-1199
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Provider Business Mailing Address
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Address Line | 2016 E ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-4223
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Country | US
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Telephone | 661-324-1000
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Fax | 661-324-1199
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HOUTAN HOSSEINI
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Credential | DDS
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Telephone | 661-324-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 41923
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License Number State | CA
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