Provider Demographics
NPI:1184741738
Name:KHZOUZ, ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:KHZOUZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 E WHITE OAK RDG
Mailing Address - Street 2:#105
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-6573
Mailing Address - Country:US
Mailing Address - Phone:714-289-1820
Mailing Address - Fax:
Practice Address - Street 1:701 S RAYMOND AVE
Practice Address - Street 2:#4B
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-5201
Practice Address - Country:US
Practice Address - Phone:714-992-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist