| Fard & Mastour Dental Group | |
|
15720 Ventura Blvd Suite 514 Encino CA 91436-2914 | |
| (818) 990-6659 | |
| Not Available |
| Full Name | Fard & Mastour Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 15720 Ventura Blvd, Encino, California |
| Authorized Official Name and Position | Arash Sabbagh Fard (PRESIDENT) |
| Authorized Official Contact | 8189906659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fard & Mastour Dental Group 15720 Ventura Blvd Suite 514 Encino CA 91436-2914 Ph: (818) 990-6659 | Fard & Mastour Dental Group 15720 Ventura Blvd Suite 514 Encino CA 91436-2914 Ph: (818) 990-6659 |
| NPI Number | 1740694249 |
|---|---|
| Provider Enumeration Date | 06/12/2014 |
| Last Update Date | 06/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740694249 | NPI | - | NPPES |
| 48007 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 48007 (California) | Primary |
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