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Organization
BALOUCH DDS CORPORATION
Active
Organization
BALOUCH DDS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI BALOUCH (CEO)
(818) 396-3999
Entity
Organization
Contact information
Practice address
8628 VAN NUYS BLVD # 200, PANORAMA CITY, CA 91402-2913
(818) 895-1321
Mailing address
1435 ANDENES DR, GLENDALE, CA 91208-1910
(818) 396-3999
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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