| Choice Dental Group | |
|
12730 Hawthorne Blvd Ste D Hawthorne CA 90250-3919 | |
| (310) 644-4000 | |
| (310) 644-3232 |
| Full Name | Choice Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 12730 Hawthorne Blvd Ste D, Hawthorne, California |
| Authorized Official Name and Position | Farid Pakravan (OWNER) |
| Authorized Official Contact | 3108209933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Choice Dental Group 12730 Hawthorne Blvd Ste D Hawthorne CA 90250-3919 Ph: (310) 644-4000 | Choice Dental Group 12730 Hawthorne Blvd Ste D Hawthorne CA 90250-3919 Ph: (310) 644-4000 |
| NPI Number | 1720324494 |
|---|---|
| Provider Enumeration Date | 12/27/2012 |
| Last Update Date | 12/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720324494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 39862 (California) | Primary |
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