Organization
EBI NIKJOO DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBI DONAVAN NIKJOO DDS (OWNER)
(562) 422-1000
Entity
Organization
Contact information
Practice address
5399 ORANGE AVE, LONG BEACH, CA 90805-6017
(562) 422-1000
Mailing address
5399 ORANGE AVE, LONG BEACH, CA 90805-6017
(562) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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