| S & S Khosh Dds Inc | |
|
2114 N Glenoaks Blvd Burbank CA 91504-2827 | |
| (818) 846-8915 | |
| (818) 846-0958 |
| Full Name | S & S Khosh Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 2114 N Glenoaks Blvd, Burbank, California |
| Authorized Official Name and Position | Shayesteh Rostamkolaie Khosh (DENTIST) |
| Authorized Official Contact | 8188468915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S & S Khosh Dds Inc 2114 N Glenoaks Blvd Burbank CA 91504-2827 Ph: (818) 846-8915 | S & S Khosh Dds Inc 2114 N Glenoaks Blvd Burbank CA 91504-2827 Ph: (818) 846-8915 |
| NPI Number | 1548454960 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 08/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548454960 | NPI | - | NPPES |
| G9402201 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 42879 (California) | Primary |
| 122300000X | Dentist | 40633 (California) | Secondary |
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