Provider Demographics
NPI:1639432826
Name:NAZLI ASRAR, D.D.S., INC.
Entity Type:Organization
Organization Name:NAZLI ASRAR, D.D.S., INC.
Other - Org Name:PEARL DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIS/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASRAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-596-5959
Mailing Address - Street 1:2082 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-3559
Mailing Address - Country:US
Mailing Address - Phone:909-596-5959
Mailing Address - Fax:
Practice Address - Street 1:2082 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-3559
Practice Address - Country:US
Practice Address - Phone:909-596-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty