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5442 Ygnacio Valley Rd Suite 70 Concord CA 94521 | |
| (925) 524-0444 | |
| (925) 524-2472 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5442 Ygnacio Valley Rd, Concord, California |
| Authorized Official Name and Position | Mehran Haidari (PRESIDENT/ OWNER) |
| Authorized Official Contact | 9255240444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5442 Ygnacio Valley Rd Ste 70 Concord CA 94521-3827 Ph: (925) 524-0444 | 5442 Ygnacio Valley Rd Suite 70 Concord CA 94521 Ph: (925) 524-0444 |
| NPI Number | 1346769452 |
|---|---|
| Provider Enumeration Date | 09/11/2017 |
| Last Update Date | 09/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346769452 | NPI | - | NPPES |
| 1598989741 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 101324 (California) | Primary |
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