| Timothy Samuel Shahbazian Dds And Dale Howard Minkin Dds | |
|
2111 Parkside Dr Suite B Fremont CA 94536-5325 | |
| (510) 797-9100 | |
| (510) 797-3429 |
| Full Name | Timothy Samuel Shahbazian Dds And Dale Howard Minkin Dds |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2111 Parkside Dr, Fremont, California |
| Authorized Official Name and Position | Timothy Samuel Shahbazian (PARTNER OWNER) |
| Authorized Official Contact | 5107979100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Samuel Shahbazian Dds And Dale Howard Minkin Dds 2111 Parkside Dr Suite B Fremont CA 94536-5325 Ph: (510) 797-9100 | Timothy Samuel Shahbazian Dds And Dale Howard Minkin Dds 2111 Parkside Dr Suite B Fremont CA 94536-5325 Ph: (510) 797-9100 |
| NPI Number | 1326189028 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326189028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 28087 (California) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 38564 (California) | Secondary |
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