| Maverick Bani, D.D.S., Inc. | |
|
709 N Lake Ave Pasadena CA 91104-4558 | |
| (626) 797-8900 | |
| Not Available |
| Full Name | Maverick Bani, D.D.S., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 709 N Lake Ave, Pasadena, California |
| Authorized Official Name and Position | Maverick Bani (PRESIDENT) |
| Authorized Official Contact | 3109930417 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maverick Bani, D.D.S., Inc. 620 N Arden Dr Beverly Hills CA 90210-3510 Ph: (310) 993-0417 | Maverick Bani, D.D.S., Inc. 709 N Lake Ave Pasadena CA 91104-4558 Ph: (626) 797-8900 |
| NPI Number | 1124853072 |
|---|---|
| Provider Enumeration Date | 09/02/2024 |
| Last Update Date | 09/02/2024 |
| Certification Date | 09/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124853072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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