| Payam Behradnia Dmo, A Dental Corp | |
|
4757 Hoen Ave Santa Rosa CA 95405-7862 | |
| (707) 575-9595 | |
| (707) 575-5122 |
| Full Name | Payam Behradnia Dmo, A Dental Corp |
|---|---|
| Speciality | Dentist |
| Location | 4757 Hoen Ave, Santa Rosa, California |
| Authorized Official Name and Position | Payam Behradnia (CEO) |
| Authorized Official Contact | 7075759595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Payam Behradnia Dmo, A Dental Corp 4757 Hoen Ave Santa Rosa CA 95405-7862 Ph: (707) 575-9595 | Payam Behradnia Dmo, A Dental Corp 4757 Hoen Ave Santa Rosa CA 95405-7862 Ph: (707) 575-9595 |
| NPI Number | 1316332000 |
|---|---|
| Provider Enumeration Date | 03/31/2015 |
| Last Update Date | 03/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316332000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 60893 (California) | Primary |
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