Provider Demographics
NPI:1588051593
Name:POOJA ANISH ASWANI,A DENTAL CORPORATION
Entity type:Organization
Organization Name:POOJA ANISH ASWANI,A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASWANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-869-5527
Mailing Address - Street 1:7901 SANTA MONICA BLVD
Mailing Address - Street 2:#111
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5177
Mailing Address - Country:US
Mailing Address - Phone:323-822-1222
Mailing Address - Fax:323-822-1322
Practice Address - Street 1:7901 SANTA MONICA BLVD
Practice Address - Street 2:#111
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5177
Practice Address - Country:US
Practice Address - Phone:323-822-1222
Practice Address - Fax:323-822-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49282261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental