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General NPI Number Information
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NPI Number | 1619545159
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Entity Type | Organization
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Legal Business Name | TASKER AND ROWAN DENTAL CORPORATION OF BEVERLY HILLS
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 8635 W 3RD ST STE 255
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City | LOS ANGELES
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State | CA
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Zip | 90048-6113
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Country | US
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Telephone | 916-479-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 8635 W 3RD ST STE 255
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City | LOS ANGELES
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State | CA
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Zip | 90048-6113
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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 | DIRECTOR OF OPERATIONS
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Name | JEANNINE SASO
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Credential |
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Telephone | 916-479-3432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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