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General NPI Number Information
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NPI Number | 1841607652
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Entity Type | Individual
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Provider Name | BABAK FOROOGHI DDS
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Gender | Male
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 15720 VENTURA BLVD. SUITE 311
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City | ENCINO
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State | CA
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Zip | 90272
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Country | US
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Telephone | 310-666-7825
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Fax |
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Provider Business Mailing Address
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Address Line | 15720 VENTURA BLVD. SUITE 311
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City | ENCINO
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State | CA
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Zip | 90272
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Country | US
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Telephone | 872-222-8722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 63625
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License Number State | CA
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