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Organization
PAKRAVAN, MANAVI & COHEN DENTAL CORPORATION
Active
Organization
PAKRAVAN, MANAVI & COHEN DENTAL CORPORATION
Active
Other names
WEST COAST DENTAL GROUP OF RANCHO CUCAMONGA
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (Q/A CONTRACT & COMPLIANCE MANAGER)
(310) 820-9933
Entity
Organization
Contact information
Practice address
7210 DAY CREEK BLVD, SUITE 110, RANCHO CUCAMONGA, CA 91739
(310) 820-9933
(310) 820-0408
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
(310) 820-0408
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39862
CA
Other
Enumeration date
03/01/2018
Last updated
07/30/2020
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