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Organization

MERVAT S. BAKHOUM, D.D.S.

Active
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Organization

MERVAT S. BAKHOUM, D.D.S.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MANEESH A. BANSAL (ADMINISTRATOR)
(323) 478-1101
Entity
Organization

Contact information

Practice address
5540 N FIGUEROA ST, LOS ANGELES, CA 90042-4120
(323) 478-1101
Mailing address
5540 N FIGUEROA ST, LOS ANGELES, CA 90042-4120
(323) 478-1101

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39940
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G94072-02
—
CA
Enumeration date
02/25/2008
Last updated
02/25/2008
About Stedi
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