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General NPI Number Information
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NPI Number | 1457997165
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Entity Type | Organization
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Legal Business Name | O.R. H.R. BARKHORDAR DENTAL INC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 18000 STUDEBAKER RD STE 365
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City | CERRITOS
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State | CA
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Zip | 90703-2690
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Country | US
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Telephone | 562-202-5741
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Fax |
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Provider Business Mailing Address
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Address Line | 18000 STUDEBAKER RD STE 365
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City | CERRITOS
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State | CA
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Zip | 90703-2690
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Country | US
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Telephone | 562-202-5741
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Fax |
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Authorized Official
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Title or Position | ASSISTANT MANAGER
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Name | MONIQUE VELOZ
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Credential |
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Telephone | 562-928-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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