| Burbank/glendale Dental Group | |
|
500 E Olive Ave 430 Burbank CA 91501-3316 | |
| (818) 567-4662 | |
| (818) 567-0554 |
| Full Name | Burbank/glendale Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 500 E Olive Ave, Burbank, California |
| Authorized Official Name and Position | Behzad Shirazi Ardestani (OWNER) |
| Authorized Official Contact | 8185674662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Burbank/glendale Dental Group 500 E Olive Ave 430 Burbank CA 91501-3316 Ph: (818) 567-4662 | Burbank/glendale Dental Group 500 E Olive Ave 430 Burbank CA 91501-3316 Ph: (818) 567-4662 |
| NPI Number | 1003082074 |
|---|---|
| Provider Enumeration Date | 04/30/2008 |
| Last Update Date | 04/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003082074 | NPI | - | NPPES |
| G91547-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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