| Childrens Dental Funzone | |
|
6846 Reseda Blvd Ste C Reseda CA 91335-8512 | |
| (310) 625-3773 | |
| Not Available |
| Full Name | Childrens Dental Funzone |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6846 Reseda Blvd Ste C, Reseda, California |
| Authorized Official Name and Position | Fariborz Rodef (OWNER) |
| Authorized Official Contact | 6264120200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dental Funzone 6846 Reseda Blvd Ste C Reseda CA 91335-8512 Ph: (310) 625-3773 | Childrens Dental Funzone 6846 Reseda Blvd Ste C Reseda CA 91335-8512 Ph: (310) 625-3773 |
| NPI Number | 1912367012 |
|---|---|
| Provider Enumeration Date | 03/02/2016 |
| Last Update Date | 10/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912367012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 38356 (California) | Primary |
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