Organization
BAMSHAD DENTAL CORPORATION
Active
Other names
Bamshad Dental Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEYVAN BAMSHAD DDS (OWNER/ DENTIST)
(818) 345-6477
Entity
Organization
Contact information
Practice address
19231 VICTORY BLVD STE 458, RESEDA, CA 91335-6368
(818) 345-6477
(818) 345-1509
Mailing address
19231 VICTORY BLVD STE 458, RESEDA, CA 91335-6368
(818) 345-6477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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