Individual
GHASSEM ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSC, PHD
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3006
(310) 206-7597
(310) 825-9460
Mailing address
10833 LE CONTE AVE RM 23-019, LOS ANGELES, CA 90095-1668
(310) 206-7597
(310) 825-9460
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
319
CA
1223P0221X
Pediatric Dentistry
DRPM2639
FL
Other
Enumeration date
07/21/2023
Last updated
08/25/2024
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