| S. Shaun Daneshgar Dmd Inc | |
|
2771 E Florence Ave Ste E Huntington Park CA 90255-5750 | |
| (310) 701-0770 | |
| Not Available |
| Full Name | S. Shaun Daneshgar Dmd Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2771 E Florence Ave Ste E, Huntington Park, California |
| Authorized Official Name and Position | Michael Daneshgar (OFFICE MANAGER) |
| Authorized Official Contact | 3107010770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S. Shaun Daneshgar Dmd Inc 2771 E Florence Ave Ste E Huntington Park CA 90255-5750 Ph: (310) 701-0770 | S. Shaun Daneshgar Dmd Inc 2771 E Florence Ave Ste E Huntington Park CA 90255-5750 Ph: (310) 701-0770 |
| NPI Number | 1235607425 |
|---|---|
| Provider Enumeration Date | 11/06/2018 |
| Last Update Date | 06/13/2019 |
| Medicare PECOS PAC ID | 7911338298 |
|---|---|
| Medicare Enrollment ID | O20200521000733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235607425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Shaun S Daneshgar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1104934983 PECOS PAC ID: 8527227198 Enrollment ID: I20120319000153 |
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