MEDICARE: EFTEKHARI, DDS, INC ( UNITED DENTAL CARE )

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

General Provider Information

NPI Number	:	1780651810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EFTEKHARI, DDS, INC ( UNITED DENTAL CARE )

Provider Business Mailing Address
First Line	:	3909 SEPULVEDA BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4607
Country	:	US
Telephone Number	:	310-390-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3909 SEPULVEDA BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4607
Country	:	US
Telephone Number	:	310-390-6000
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ABBAS EFTEKHARI
Credential	:	D. D. S.
Telephone Number	:	310-390-6000

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	09/21/2009

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