Iraj Nouri Dds Inc. | |
1239 N Avalon Blvd Wilmington CA 90744-2601 | |
(310) 518-2697 | |
(310) 518-6864 |
Full Name | Iraj Nouri Dds Inc. |
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Speciality | Dentist - General Practice |
Location | 1239 N Avalon Blvd, Wilmington, California |
Authorized Official Name and Position | Iraj Nouri (OWNER DENTIST) |
Authorized Official Contact | 3105182697 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Iraj Nouri Dds Inc. 1239 N Avalon Blvd Wilmington CA 90744-2601 Ph: (310) 518-2697 | Iraj Nouri Dds Inc. 1239 N Avalon Blvd Wilmington CA 90744-2601 Ph: (310) 518-2697 |
NPI Number | 1346447877 |
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Provider Enumeration Date | 06/28/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346447877 | NPI | - | NPPES |
B39856-01 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 39856 (California) | Primary |
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