| Miles Madison D D S Inc | |
|
350 S Beverly Dr Ste 160 Beverly Hills CA 90212-4815 | |
| (310) 553-2940 | |
| (310) 553-5096 |
| Full Name | Miles Madison D D S Inc |
|---|---|
| Speciality | Dentist |
| Location | 350 S Beverly Dr Ste 160, Beverly Hills, California |
| Authorized Official Name and Position | Miles Madison (OWNER) |
| Authorized Official Contact | 3105532940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miles Madison D D S Inc 350 S Beverly Dr Ste 160 Beverly Hills CA 90212-4815 Ph: (310) 553-2940 | Miles Madison D D S Inc 350 S Beverly Dr Ste 160 Beverly Hills CA 90212-4815 Ph: (310) 553-2940 |
| NPI Number | 1538662036 |
|---|---|
| Provider Enumeration Date | 03/12/2018 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 0648601773 |
|---|---|
| Medicare Enrollment ID | O20200505002646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538662036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 37446 (California) | Primary |
| Provider Name | Saman Harouni |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1770929572 PECOS PAC ID: 2365874724 Enrollment ID: I20200316002308 |
| Provider Name | Miles Madison |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1477687580 PECOS PAC ID: 3870897135 Enrollment ID: I20200505002765 |
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