# DR AFZALIS LAKE FOREST LIFETIME DENTAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093107377
- **Authorized official:** DR. AZADEH M AFZALI DDS (PRESIDENT)
- **Authorized official phone:** (949) 581-8108

## Contact information

- **Practice address:** 23731 EL TORO RD STE D, LAKE FOREST, CA 92630-8615
- **Practice address phone:** (949) 581-8108
- **Mailing address:** 23731 EL TORO RD STE D, LAKE FOREST, CA 92630-8615
- **Mailing address phone:** (949) 581-8108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 55014 | CA | Yes |

## Other

- **Enumeration date:** 02/24/2015
- **Last updated:** 08/09/2018