Organization
RAVON & BASHAWATY DENTAL PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN LYNN NITTA (OFFICE MANAGER)
(559) 259-5650
Entity
Organization
Contact information
Practice address
9675 BRIGHTON WAY PH A, BEVERLY HILLS, CA 90210-5164
(310) 275-3842
(480) 275-3842
Mailing address
2457 W BEECHWOOD AVE, FRESNO, CA 93711-7015
(559) 259-5650
(480) 275-3842
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
49913
CA
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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