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Organization
ROBERT BOOTEHSAZ DMD INC
Active
Organization
ROBERT BOOTEHSAZ DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT BOOTEHSAZ DMD (OWNER)
(818) 304-8021
Entity
Organization
Contact information
Practice address
19458 VENTURA BLVD STE 10, TARZANA, CA 91356-3037
(818) 304-8021
(818) 304-8029
Mailing address
19458 VENTURA BLVD. STE 10, TARZANA, CA 91356-3042
(818) 304-8021
(818) 304-8029
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
56953
CA
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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