Organization
THOUSAND OAKS CHILDRENS DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AHSAN S RAZA D.D.S. (OWNER/PARTNER)
(805) 497-3797
Entity
Organization
Contact information
Practice address
61 LONG CT, SUITE 202, THOUSAND OAKS, CA 91360
(805) 497-3797
(805) 371-1121
Mailing address
61 LONG CT, SUITE 202, THOUSAND OAKS, CA 91360
(805) 497-3797
(805) 371-1121
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
036029
CA
Other
Enumeration date
04/04/2007
Last updated
02/04/2009
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