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Organization
H.R.IMANKHAN,DDS,INC
Active
Organization
H.R.IMANKHAN,DDS,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAMID REZA IMANKHAN DDS (PRESIDENT/OWNER)
(310) 639-0884
Entity
Organization
Contact information
Practice address
11395 ATLANTIC AVE, LYNWOOD, CA 90262-2485
(310) 639-0884
(310) 639-0013
Mailing address
11395 ATLANTIC AVE, LYNWOOD, CA 90262-2485
(310) 639-0884
(310) 639-0013
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G893997-01
DENTI-CAL
CA
Enumeration date
03/25/2011
Last updated
11/10/2023
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