Organization
A SABBAGH-FARD DDS & P. MASTOUR DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEDRAM E. MASTOUR D.D.S (DENTIST)
(310) 390-6212
Entity
Organization
Contact information
Practice address
5620 SAWTELLE BLVD, CULVER CITY, CA 90230-5508
(310) 390-6212
(310) 390-6215
Mailing address
5620 SAWTELLE BLVD, CULVER CITY, CA 90230-5508
(310) 390-6212
(310) 390-6215
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
CA
1223P0300X
Periodontics
—
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
CA
305R00000X
Preferred Provider Organization
—
CA
Other
Enumeration date
08/27/2012
Last updated
07/21/2022
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