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Organization
HEAVENLY DENTAL
Active
Organization
HEAVENLY DENTAL
Active
Other names
Heavenly Dental
Organization subpart
No
Provider details
NPI number
Authorized official
NOUSHIN FANI DDS (OWNER)
(818) 837-9744
Entity
Organization
Contact information
Practice address
321 N MACLAY AVE, SUITE A, SAN FERNANDO, CA 91340
(818) 837-9744
(818) 837-9303
Mailing address
321 N MACLAY AVE, SUITE A, SAN FERNANDO, CA 91340
(818) 837-9744
(818) 837-9303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39149
CA
Other
Enumeration date
02/02/2007
Last updated
08/22/2020
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