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1306 W Avenue J Ste A Lancaster CA 93534-2936 | |
| (844) 563-2453 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1306 W Avenue J Ste A, Lancaster, California |
| Authorized Official Name and Position | Reza Shirazi (DENTAL DIRECTOR) |
| Authorized Official Contact | 8445632453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1306 W Avenue J Ste A Lancaster CA 93534-2936 Ph: (844) 563-2453 | 1306 W Avenue J Ste A Lancaster CA 93534-2936 Ph: (844) 563-2453 |
| NPI Number | 1538648324 |
|---|---|
| Provider Enumeration Date | 08/13/2018 |
| Last Update Date | 08/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538648324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 54475 (California) | Primary |
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