| Ansari Dental Corporation, Inc. | |
|
21310 San Ramon Valley Blvd. 2 San Ramon CA 94583-4000 | |
| (925) 828-0824 | |
| (925) 828-3426 |
| Full Name | Ansari Dental Corporation, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 21310 San Ramon Valley Blvd., San Ramon, California |
| Authorized Official Name and Position | Mahsa Jaberiansari (OWNER) |
| Authorized Official Contact | 9258280824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ansari Dental Corporation, Inc. 21310 San Ramon Valley Blvd San Ramon CA 94583-4066 Ph: (925) 828-0824 | Ansari Dental Corporation, Inc. 21310 San Ramon Valley Blvd. 2 San Ramon CA 94583-4000 Ph: (925) 828-0824 |
| NPI Number | 1780190629 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 12/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780190629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 59856 (California) | Primary |
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