Individual
BEBENAZ EHSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
16111 PLUMMER ST, NORTH HILLS, CA 91343-2036
(818) 891-7711
Mailing address
19041 EDINGTON TERR, IRVINE, CA 92603
(949) 293-8872
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61858
CA
Other
Enumeration date
10/03/2011
Last updated
06/19/2013
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