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Organization
JAMSHEED AND SOOFERI A PROFESSIONAL DENTAL CORPORATION
Active
Organization
JAMSHEED AND SOOFERI A PROFESSIONAL DENTAL CORPORATION
Active
Other names
Starlight Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAYAM SOOFERI D.D.S. (DENTIST/CEO)
(818) 243-8888
Entity
Organization
Contact information
Practice address
214 N CENTRAL AVE, GLENDALE, CA 91203-3556
(818) 243-8888
(818) 243-8808
Mailing address
214 N CENTRAL AVE, GLENDALE, CA 91203-3556
(818) 243-8888
(818) 243-8808
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
54604
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434731
BLUE SHIELD
CA
Enumeration date
04/27/2009
Last updated
04/27/2009
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