MEDICARE: DR. BURTON R. SOBELMAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	24607	CA

General Provider Information

NPI Number	:	1235212416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BURTON R. SOBELMAN D.D.S.

Provider Business Mailing Address
First Line	:	8500 WILSHIRE BLVD STE 1004
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3108
Country	:	US
Telephone Number	:	310-659-1510
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 WILSHIRE BLVD STE 1004
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3108
Country	:	US
Telephone Number	:	310-659-1510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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