Organization
H. REZA SHAHMOHAMMADI, A DENTAL CORPORATION
Active
Other names
Hamlin Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LACEY HOWELL (MANAGER)
(818) 782-6919
Entity
Organization
Contact information
Practice address
14401 HAMLIN ST, VAN NUYS, CA 91401
(818) 782-6919
(818) 988-4632
Mailing address
14401 HAMLIN ST, VAN NUYS, CA 91401
(818) 782-6919
(818) 988-4632
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
B4130701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4130701
MEDICAL PROVIDER
CA
05
—
B.41307.01
—
CA
Enumeration date
12/22/2006
Last updated
08/15/2008
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