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General NPI Number Information
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NPI Number | 1215074570
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Entity Type | Organization
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Legal Business Name | DONNY EMANUEL DMD A PROF DENTAL CORP
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 2379 N OXNARD BL
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City | OXNARD
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State | CA
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Zip | 93036
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Country | US
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Telephone | 805-278-9499
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Fax | 805-779-9799
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Provider Business Mailing Address
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Address Line | 2379 N OXNARD BL
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City | OXNARD
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State | CA
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Zip | 93036
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Country | US
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Telephone | 805-278-9499
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Fax | 805-779-9799
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Authorized Official
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Title or Position | PRES
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Name | SHAWN RABIZADEH
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Credential | DDS
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Telephone | 805-278-9499
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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 | 46324
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License Number State | CA
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