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Organization

BAYANI POUR DENTAL PARTNERSHIP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACY POUR DDS (PARTNER OWNER)
(310) 906-8972
Entity
Organization

Contact information

Practice address
17130 VENTURA BLVD # 150, ENCINO, CA 91316-4003
(818) 357-2255
Mailing address
11312 FARLIN ST, LOS ANGELES, CA 90049-3014
(310) 906-8972

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
05/10/2023
Last updated
12/07/2023
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