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General NPI Number Information
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NPI Number | 1376909002
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Entity Type | Organization
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Legal Business Name | ESHAGHIAN & PAZOOKY DENTAL CORPORATION
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Dates
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Enumeration Date | 01/11/2016
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 2978 WILSHIRE BLVD #201
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City | LOS ANGELES
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State | CA
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Zip | 90010-1126
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Country | US
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Telephone | 310-933-6033
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Fax |
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Provider Business Mailing Address
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Address Line | 2978 WILSHIRE BLVD #201
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City | LOS ANGELES
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State | CA
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Zip | 90010-1126
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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 | CO-PRESIDENT
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Name | SHARONE PAZOOKY
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Credential |
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Telephone | 310-933-6033
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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 | 59650
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License Number State | CA
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