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General NPI Number Information
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NPI Number | 1700177375
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Entity Type | Organization
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Legal Business Name | KHABBAZ AND ROUHANI DENTAL CORP
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | 21700 GOLDEN TRIANGLE RD SUITE 201
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City | SAUGUS
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State | CA
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Zip | 91350-2616
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Country | US
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Telephone | 661-259-5540
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Fax | 661-259-5571
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Provider Business Mailing Address
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Address Line | 21700 GOLDEN TRIANGLE RD SUITE 201
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City | SAUGUS
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State | CA
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Zip | 91350-2616
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Country | US
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Telephone | 661-259-5540
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Fax | 661-259-5571
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Authorized Official
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Title or Position | OWNER
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Name | DR. LILIANA GABY KHABBAZ
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Credential | D.D.S.
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Telephone | 661-259-5540
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #5
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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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