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General NPI Number Information
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NPI Number | 1356873053
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Entity Type | Organization
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Legal Business Name | KAMRAN SAHABI DENTAL CORPORATION
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 1717 3RD ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-3435
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Country | US
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Telephone | 951-200-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 3RD ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-3435
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Country | US
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Telephone |
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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. KAMRAN SAHABI
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Credential | DDS
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Telephone | 818-395-4833
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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 | 39202
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License Number State | CA
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