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General NPI Number Information
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NPI Number | 1700239225
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Entity Type | Organization
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Legal Business Name | GHAVIBONIHE DENTAL INC
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 2660 E VINEYARD AVE
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City | OXNARD
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State | CA
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Zip | 93036-1615
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Country | US
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Telephone | 805-485-8587
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Fax |
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Provider Business Mailing Address
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Address Line | 2660 E VINEYARD AVE
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City | OXNARD
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State | CA
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Zip | 93036-1615
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Country | US
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Telephone | 805-485-8587
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Fax |
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Authorized Official
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Title or Position | DDS
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Name | ALI GHAVIBONIHE
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Credential | DDS
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Telephone | 805-485-8587
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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 | 49754
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License Number State | CA
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