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Organization

MAVERICK BANI, D.D.S., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAVERICK BANI DDS (PRESIDENT)
(310) 993-0417
Entity
Organization

Contact information

Practice address
709 N LAKE AVE, PASADENA, CA 91104-4558
(626) 797-8900
Mailing address
620 N ARDEN DR, BEVERLY HILLS, CA 90210-3510
(310) 993-0417

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/02/2024
Last updated
09/02/2024
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