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Organization
ROYA MIRKHAN,DMD,MSD,INC.
Active
Organization
ROYA MIRKHAN,DMD,MSD,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROYA NAZILA MIRKHAN DMD,MSD (PRESIDENT)
(858) 337-6264
Entity
Organization
Contact information
Practice address
12395 EL CAMINO REAL, SUITE NUMBER 314, SAN DIEGO, CA 92130-3082
(858) 337-6264
(858) 755-6260
Mailing address
12395 EL CAMINO REAL, SUITE NUMBER 314, SAN DIEGO, CA 92130
(858) 337-6264
(858) 755-6260
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
44743
CA
1223P0300X
Periodontics
44743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396866000
DENTISTRY
CA
Enumeration date
06/30/2015
Last updated
06/30/2015
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