Organization
DAVID SHABANZADEH D.D.S.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SHABANZADEH D.D.S. (PRESIDENT)
(818) 448-0676
Entity
Organization
Contact information
Practice address
326 N VERMONT AVE, SUITE B, LOS ANGELES, CA 90004-3511
(323) 661-2626
Mailing address
326 N VERMONT AVE, SUITE B, LOS ANGELES, CA 90004-3511
(323) 661-2626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B 40728-02
—
CA
Enumeration date
06/18/2007
Last updated
02/17/2011
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