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Organization

SHAHRAM HOSSEINI DDS, INC.

Active
Parent organization
SHAHRAM HOSSEINI DDS, INC.
Other names
New Age Family Dental Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
SHAHRAM HOSSEINI DDS, INC.
Authorized official
SHAHRAM HOSSEINI DDS (DENTIST)
(818) 225-1630
Entity
Organization

Contact information

Practice address
23111 VENTURA BLVD, SUITE #204, WOODLAND HILLS, CA 91364-1103
(818) 225-1630
Mailing address
23111 VENTURA BLVD, SUITE #204, WOODLAND HILLS, CA 91364
(818) 225-1630

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
53068
CA

Other

Enumeration date
01/09/2012
Last updated
01/09/2012
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