Provider Demographics
NPI:1932547049
Name:ASGARI DENTAL P.C.
Entity type:Organization
Organization Name:ASGARI DENTAL P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-744-3333
Mailing Address - Street 1:309 S RANCHO SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2303
Mailing Address - Country:US
Mailing Address - Phone:760-744-3333
Mailing Address - Fax:760-744-3001
Practice Address - Street 1:309 S RANCHO SANTA FE RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2303
Practice Address - Country:US
Practice Address - Phone:760-744-3333
Practice Address - Fax:760-744-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584681223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD58468OtherDENTI-CAL RENDERING PROVIDER