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1708 S Victoria Ave Ste B Ventura CA 93003-6595 | |
| (805) 941-1001 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1708 S Victoria Ave Ste B, Ventura, California |
| Authorized Official Name and Position | Tariq Jabaiti (PRESIDENT/DENTIST) |
| Authorized Official Contact | 8059411001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1708 S Victoria Ave Ste B Ventura CA 93003-6595 Ph: (805) 941-1001 | 1708 S Victoria Ave Ste B Ventura CA 93003-6595 Ph: (805) 941-1001 |
| NPI Number | 1851930655 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 07/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851930655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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