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General NPI Number Information
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NPI Number | 1306247960
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Entity Type | Organization
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Legal Business Name | HESSAM NOWZARI DDS PHD INC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 120 S SPALDING DR SUITE 201
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-1800
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Country | US
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Telephone | 310-274-0809
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Fax | 310-274-1503
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Provider Business Mailing Address
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Address Line | 120 S SPALDING DR SUITE 201
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-1800
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Country | US
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Telephone | 310-274-0809
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HESSAM NOWZARI
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Credential | DDS, PHD
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Telephone | 310-274-0809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 52236
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License Number State | CA
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