|
| |
|
460 E Pleasant Valley Rd #b Port Hueneme CA 93041 | |
| (805) 488-1611 | |
| (805) 986-9406 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 460 E Pleasant Valley Rd, Port Hueneme, California |
| Authorized Official Name and Position | Alireza M Sharifzadeh (DENTIST) |
| Authorized Official Contact | 8054881611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
460 E Pleasant Valley Rd #b Port Hueneme CA 93041 Ph: (805) 488-1611 | 460 E Pleasant Valley Rd #b Port Hueneme CA 93041 Ph: (805) 488-1611 |
| NPI Number | 1518094291 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 10/31/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518094291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DJ035550 (California) | Primary |
Dennis L Tank Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 W Channel Islands Blvd, 203, Port Hueneme, CA 93041 Phone: 805-985-0300 | |