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General NPI Number Information
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NPI Number | 1649500018
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Entity Type | Organization
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Legal Business Name | KATI ASGARIFAR DDS, INC
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 5931 KANAN RD
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1688
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Country | US
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Telephone | 818-991-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 5931 KANAN RD
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1688
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Country | US
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Telephone | 818-991-7522
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KATI OZRA ASGARIFAR
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Credential | DDS
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Telephone | 818-991-7752
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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 | 42799
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License Number State | CA
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