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Organization
FARD & MASTOUR DENTAL GROUP
Active
Organization
FARD & MASTOUR DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARASH SABBAGH FARD DDS (PRESIDENT)
(818) 990-6659
Entity
Organization
Contact information
Practice address
15720 VENTURA BLVD, SUITE 514, ENCINO, CA 91436-2914
(818) 990-6659
Mailing address
15720 VENTURA BLVD, SUITE 514, ENCINO, CA 91436-2914
(818) 990-6659
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
48007
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48007
LICENSE
CA
Enumeration date
06/12/2014
Last updated
06/12/2014
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