Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 3009 Highway K, O'fallon, Missouri |
Authorized Official Name and Position | Alex R Sharifian (OWNER) |
Authorized Official Contact | 6363797552 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | 3009 Highway K O'fallon MO 63368 Ph: (636) 379-7552 |
NPI Number | 1407281314 |
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Provider Enumeration Date | 09/10/2013 |
Last Update Date | 09/10/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407281314 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |