| Fardad Tayebaty Dmd Inc | |
|
390 S Green Valley Rd Ste 7 Watsonville CA 95076-3077 | |
| (831) 536-5880 | |
| Not Available |
| Full Name | Fardad Tayebaty Dmd Inc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 390 S Green Valley Rd Ste 7, Watsonville, California |
| Authorized Official Name and Position | Fardad Tayebaty (PRESIDENT) |
| Authorized Official Contact | 6178753211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fardad Tayebaty Dmd Inc 5700 Village Oaks Dr Apt 1408 San Jose CA 95123-3778 Ph: (617) 875-3211 | Fardad Tayebaty Dmd Inc 390 S Green Valley Rd Ste 7 Watsonville CA 95076-3077 Ph: (831) 536-5880 |
| NPI Number | 1114439015 |
|---|---|
| Provider Enumeration Date | 10/31/2017 |
| Last Update Date | 10/31/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114439015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 100912 (California) | Primary |
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