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General NPI Number Information
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NPI Number | 1730265968
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Entity Type | Organization
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Legal Business Name | GREEN OAKS FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 2711 W GREEN OAKS BLVD
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City | ARLINGTON
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State | TX
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Zip | 76016-1671
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Country | US
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Telephone | 817-451-9292
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Fax | 817-451-3137
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Provider Business Mailing Address
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Address Line | 2711 W GREEN OAKS BLVD
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City | ARLINGTON
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State | TX
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Zip | 76016-1671
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Country | US
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Telephone | 817-451-9292
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Fax | 817-451-3137
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Authorized Official
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Title or Position | OWNER
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Name | BOBBY HASSANZADEH
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Credential | DDS
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Telephone | 817-451-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17911
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16838
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License Number State | TX
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