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General NPI Number Information
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NPI Number | 1114568326
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Entity Type | Organization
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Legal Business Name | GHAZINOOR DDS PROF.CORP
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 10/03/2019
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Provider Practice Location Address
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Address Line | 1711 E VALLEY PKWY STE 110
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City | ESCONDIDO
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State | CA
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Zip | 92027-2521
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Country | US
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Telephone | 760-877-7761
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 E VALLEY PKWY STE 1101711E
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City | ESCONDIDO
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State | CA
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Zip | 92027-2521
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Country | US
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Telephone | 760-877-7761
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AMIR H GHAZINOOR
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Credential | DDS
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Telephone | 760-877-7761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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