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8320 Desoto Ave Canoga Park CA 91304-2701 | |
| (818) 883-1234 | |
| (818) 883-9781 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8320 Desoto Ave, Canoga Park, California |
| Authorized Official Name and Position | Behnaz Sepehripour (OWNER DENTIST) |
| Authorized Official Contact | 8188831234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8320 Desoto Ave Canoga Park CA 91304-1746 Ph: (818) 883-1234 | 8320 Desoto Ave Canoga Park CA 91304-2701 Ph: (818) 883-1234 |
| NPI Number | 1609045939 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 01/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609045939 | NPI | - | NPPES |
| G9416401 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42224 (California) | Primary |
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