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General NPI Number Information
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NPI Number | 1245134527
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Entity Type | Organization
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Legal Business Name | SUZAN SABAGH DENTAL CORPORATION
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 11980 SAN VICENTE BLVD STE 814
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City | LOS ANGELES
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State | CA
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Zip | 90049-6606
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Country | US
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Telephone | 310-493-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 15507 S NORMANDIE AVE # 424
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City | GARDENA
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State | CA
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Zip | 90247-4013
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Country | US
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Telephone | 310-493-1133
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUZAN SABAGH
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Credential | DDS
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Telephone | 310-493-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number |
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License Number State | NULL
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