| David Shabanzadeh D.d.s.,inc. | |
|
326 N Vermont Ave Suite B Los Angeles CA 90004-3511 | |
| (323) 661-2626 | |
| Not Available |
| Full Name | David Shabanzadeh D.d.s.,inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 326 N Vermont Ave, Los Angeles, California |
| Authorized Official Name and Position | David Shabanzadeh (PRESIDENT) |
| Authorized Official Contact | 8184480676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Shabanzadeh D.d.s.,inc. 326 N Vermont Ave Suite B Los Angeles CA 90004-3511 Ph: (323) 661-2626 | David Shabanzadeh D.d.s.,inc. 326 N Vermont Ave Suite B Los Angeles CA 90004-3511 Ph: (323) 661-2626 |
| NPI Number | 1356546550 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 02/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356546550 | NPI | - | NPPES |
| B 40728-02 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 40728 (California) | Primary |
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