| Mortezaiefard Dental Corp | |
|
22110 Roscoe Blvd Ste 101 West Hills CA 91304-3859 | |
| (818) 888-4004 | |
| Not Available |
| Full Name | Mortezaiefard Dental Corp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 22110 Roscoe Blvd Ste 101, West Hills, California |
| Authorized Official Name and Position | Golsahn Mortezaiefard (OWNER) |
| Authorized Official Contact | 8188884004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortezaiefard Dental Corp 22110 Roscoe Blvd Ste 101 West Hills CA 91304-3859 Ph: () - | Mortezaiefard Dental Corp 22110 Roscoe Blvd Ste 101 West Hills CA 91304-3859 Ph: (818) 888-4004 |
| NPI Number | 1720247638 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720247638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | B39049 (California) | Primary |
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