| The Culver Marina Dental Group | |
|
12756 West Washington Blvd Los Angeles CA 90066 | |
| (310) 822-6066 | |
| Not Available |
| Full Name | The Culver Marina Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 12756 West Washington Blvd, Los Angeles, California |
| Authorized Official Name and Position | Pegah Ghassemi Bakhtiari (DR) |
| Authorized Official Contact | 8186325877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Culver Marina Dental Group 12756 W Washington Blvd Los Angeles CA 90066-2309 Ph: (310) 822-6066 | The Culver Marina Dental Group 12756 West Washington Blvd Los Angeles CA 90066 Ph: (310) 822-6066 |
| NPI Number | 1659820686 |
|---|---|
| Provider Enumeration Date | 10/03/2016 |
| Last Update Date | 10/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659820686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 64404 (California) | Primary |
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