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Organization
POURSHIRAZI H CORPORATION
Active
Organization
POURSHIRAZI H CORPORATION
Active
Other names
Diamond Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
KEELY ANDERSON GREENO (OFFICE COORDINATOR)
(951) 672-9457
Entity
Organization
Contact information
Practice address
31500 GRAPE ST, SUITE 8, LAKE ELSINORE, CA 92532-9702
(951) 471-1628
(951) 471-1638
Mailing address
31500 GRAPE ST, SUITE 8, LAKE ELSINORE, CA 92532-9702
(951) 471-1628
(951) 471-1638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
CA
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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