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General NPI Number Information
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NPI Number | 1528140159
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Entity Type | Organization
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Legal Business Name | GLENDALE DENTAL CENTER MAJID GHORBANI DDS INC.
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 1222 S GLENDALE AVE UNIT 2
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City | GLENDALE
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State | CA
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Zip | 91205-3261
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Country | US
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Telephone | 818-547-1055
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Fax | 818-547-2631
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Provider Business Mailing Address
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Address Line | 1222 S GLENDALE AVE UNIT 2
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City | GLENDALE
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State | CA
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Zip | 91205-3261
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Country | US
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Telephone | 818-547-1055
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Fax | 818-547-2631
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | MR. MAJID GHORBANI
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Credential | DDS
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Telephone | 818-547-1055
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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 | 44885
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License Number State | CA
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