Mastour & Fard Dental Corp
NPI #1548730450 in Newberry Park, California
Provider Information
- NPI Number
- 1548730450
- Entity Type
- Organization
- Organization Name
- Mastour & Fard Dental Corp
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Dec 4, 2018
- Last Updated
- Oct 23, 2019
Practice Location
- Address
- 587 N. VENTU PARK ROAD.
- Address 2
- SUITE C
- City
- Newberry Park
- State
- California
- ZIP Code
- 91320
- Phone
- (805) 499-1253
Authorized Official
- Name
- PEDRAM MASTOUR, DDS
- Title
- OWNER
- Phone
- (310) 804-0414
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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