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General NPI Number Information
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NPI Number | 1477848976
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Entity Type | Organization
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Legal Business Name | NASIR TAHGHIGHI DENTAL CORP
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 22642 WATERBURY ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-4925
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Country | US
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Telephone | 818-441-8898
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 614
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City | WOODLAND HILLS
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State | CA
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Zip | 91365-0614
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Country | US
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Telephone | 818-441-8898
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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. NASIR TAHGHIGHI
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Credential |
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Telephone | 818-441-8898
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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 | 54030
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License Number State | CA
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