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General NPI Number Information
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NPI Number | 1831425214
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Entity Type | Organization
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Legal Business Name | MARJAN GARMESTANI DDS INC.
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 22030 SHERMAN WAY SUITE 317
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City | CANOGA PARK
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State | CA
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Zip | 91303-1855
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Country | US
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Telephone | 818-610-2007
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Fax | 818-610-2232
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Provider Business Mailing Address
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Address Line | 22030 SHERMAN WAY SUITE 317
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City | CANOGA PARK
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State | CA
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Zip | 91303-1855
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Country | US
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Telephone | 818-610-2007
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Fax | 818-610-2232
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Authorized Official
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Title or Position | DENTIST/ OWNER
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Name | MARJAN GARMESTANI
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Credential | DDS
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Telephone | 818-610-2007
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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 | 45862
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License Number State | CA
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