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521 W Channel Islands Blvd Ste 8 Port Hueneme CA 93041-2132 | |
(805) 815-4356 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 521 W Channel Islands Blvd Ste 8, Port Hueneme, California |
Authorized Official Name and Position | Kosha Shah (PRESIDENT) |
Authorized Official Contact | 8058154356 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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521 W Channel Islands Blvd Ste 8 Port Hueneme CA 93041-2132 Ph: (805) 815-4356 | 521 W Channel Islands Blvd Ste 8 Port Hueneme CA 93041-2132 Ph: (805) 815-4356 |
NPI Number | 1922139641 |
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Provider Enumeration Date | 03/07/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1922139641 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Dennis L Tank Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 W Channel Islands Blvd, 203, Port Hueneme, CA 93041 Phone: 805-985-0300 | |