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General NPI Number Information
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NPI Number | 1992861645
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Entity Type | Organization
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Legal Business Name | AMIR SAZ, DDS, A DENTAL CORPORATION
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 1104 REDONDO BEACH BLVD
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City | GARDENA
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State | CA
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Zip | 90247
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Country | US
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Telephone | 310-366-7666
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Fax | 310-366-7587
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Provider Business Mailing Address
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Address Line | 1104 REDONDO BEACH BLVD
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City | GARDENA
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State | CA
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Zip | 90247
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Country | US
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Telephone | 310-366-7666
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Fax | 310-366-7587
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMIR SAZ
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Credential | DDS
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Telephone | 310-366-7666
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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 | 36368
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License Number State | CA
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