# 6TH STREET FAMILY DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194879627
- **Authorized official:** SUSAN HAZANY DDS (PARTNER)
- **Authorized official phone:** (213) 484-2100

## Contact information

- **Practice address:** 2065 W 6TH STREET, SUITE 109, LOS ANGELES, CA 90057
- **Practice address phone:** (213) 484-2100
- **Practice address fax:** (213) 484-1474
- **Mailing address:** 2065 W 6TH STREET, SUITE 109, LOS ANGELES, CA 90057
- **Mailing address phone:** (213) 484-2100
- **Mailing address fax:** (213) 484-1474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 39963 | CA | Yes |
| 122300000X | Dentist | 41084 | CA | — |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 06/13/2008