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Organization
KHAZALI DENTAL CORPORATION
Active
Organization
KHAZALI DENTAL CORPORATION
Active
Other names
MAIN STREET DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARAL KHAZALI DDS (OWNER DDS)
(805) 644-6110
Entity
Organization
Contact information
Practice address
4360-C E MAIN ST, VENTURA, CA 93003
(805) 644-6110
(805) 644-6160
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 508-3600
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/26/2006
Last updated
02/04/2022
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