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General NPI Number Information
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NPI Number | 1770717480
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Entity Type | Organization
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Legal Business Name | DR. VIVIEN M. MAGHIRAN DENTAL CORP
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 14755 FOOTHILL BLVD SUITE E
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City | FONTANA
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State | CA
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Zip | 92335-8025
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Country | US
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Telephone | 909-349-1360
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Fax | 909-349-1290
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Provider Business Mailing Address
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Address Line | 14755 FOOTHILL BLVD SUITE E
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City | FONTANA
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State | CA
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Zip | 92335-8025
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Country | US
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Telephone | 909-349-1360
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Fax | 909-349-1290
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Authorized Official
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Title or Position | CEO
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Name | MRS. VIVIEN MATIBAS MAGHIRAN
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Credential | DMD
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Telephone | 818-268-7790
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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 |
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License Number State |
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