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General NPI Number Information
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NPI Number | 1699184960
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Entity Type | Organization
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Legal Business Name | TEBOUL AND ZARGARPOUR DENTAL CORPORATION
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 18399 VENTURA BLVD #234
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City | TARZANA
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State | CA
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Zip | 91356-4233
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Country | US
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Telephone | 818-708-3232
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Fax | 818-708-7202
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Provider Business Mailing Address
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Address Line | 18399 VENTURA BLVD #234
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City | TARZANA
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State | CA
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Zip | 91356-4233
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Country | US
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Telephone | 818-708-3232
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Fax | 818-708-7202
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. SIAVASH ZARGARPOUR
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Credential | DDS
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Telephone | 818-708-3232
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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 | 45072
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License Number State | CA
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