Organization
KRASNODARA GASHPAROVA, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRASNODARA N GASHPAROVA DDS (PRESIDENT)
(818) 572-6375
Entity
Organization
Contact information
Practice address
1933 W VALLEY BLVD, ALHAMBRA, CA 91803-2346
(626) 289-6131
(626) 289-0408
Mailing address
1933 W VALLEY BLVD, ALHAMBRA, CA 91803-2346
(626) 289-6131
(626) 289-0408
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
53452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
TAXONOMY
CA
01
—
1235317033
NPI TYPE 1
CA
Enumeration date
05/26/2008
Last updated
05/26/2008
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