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Organization
FOROUTAN DENTAL CORP
Active
Organization
FOROUTAN DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA CHAVEZ (ADMIN)
(949) 644-9181
Entity
Organization
Contact information
Practice address
8951 KNOTT AVE STE L, BUENA PARK, CA 90620-4108
(714) 826-4181
Mailing address
8951 KNOTT AVE STE L, BUENA PARK, CA 90620-4108
(714) 826-4181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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