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Organization
PAYAM SOOFERI D.D.S., A PROFESSIONAL DENTAL CORPORATION
Active
Organization
PAYAM SOOFERI D.D.S., A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAYAM SOOFERI D.D.S. (DENTIST/OWNER)
(818) 243-8888
Entity
Organization
Contact information
Practice address
207 N CENTRAL AVE, GLENDALE, CA 91203-2510
(818) 243-8888
(818) 243-8808
Mailing address
207 N CENTRAL AVE, GLENDALE, CA 91203-2510
(818) 243-8888
(818) 243-8808
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434731
BLUE SHIELD
CA
Enumeration date
04/20/2009
Last updated
08/03/2016
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