Provider Demographics
NPI:1407052343
Name:BEBER DENTAL CORPORATION
Entity Type:Organization
Organization Name:BEBER DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-881-6780
Mailing Address - Street 1:19528 VENTURA BLVD
Mailing Address - Street 2:SUITE # 322
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2917
Mailing Address - Country:US
Mailing Address - Phone:818-881-6780
Mailing Address - Fax:818-975-5098
Practice Address - Street 1:19528 VENTURA BLVD
Practice Address - Street 2:SUITE #322
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2917
Practice Address - Country:US
Practice Address - Phone:818-881-6780
Practice Address - Fax:818-975-5098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty