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General NPI Number Information
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NPI Number | 1336327972
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Entity Type | Organization
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Legal Business Name | FEIZBAKHSH DENTAL CORP
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 11628 SANTA MONICA BLVD STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90025-2900
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Country | US
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Telephone | 310-207-1060
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Fax | 310-207-6151
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Provider Business Mailing Address
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Address Line | 11628 SANTA MONICA BLVD STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90025-2900
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Country | US
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Telephone | 310-207-1060
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Fax | 310-207-6151
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ANNA L TORRES
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Credential |
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Telephone | 310-207-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 40238
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License Number State | CA
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