Provider Demographics
NPI:1750817961
Name:ZAREH FAMILY DENTAL INC.
Entity Type:Organization
Organization Name:ZAREH FAMILY DENTAL INC.
Other - Org Name:DOCDENTAL SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-679-6677
Mailing Address - Street 1:28401 BRADLEY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-3040
Mailing Address - Country:US
Mailing Address - Phone:951-679-6677
Mailing Address - Fax:951-679-6633
Practice Address - Street 1:28401 BRADLEY RD
Practice Address - Street 2:SUITE B
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-3040
Practice Address - Country:US
Practice Address - Phone:951-679-6677
Practice Address - Fax:951-679-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty