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Organization
SHAHIN MAHALLATI DDS INC
Active
Organization
SHAHIN MAHALLATI DDS INC
Active
Other names
Aqua Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHIN MAHALLATI DDS (OWNER/PRESIDENT)
(714) 640-2836
Entity
Organization
Contact information
Practice address
1319 N MAIN ST, SANTA ANA, CA 92701-2318
(714) 972-2782
Mailing address
3620 S BRISTOL ST, SUITE 307, SANTA ANA, CA 92704-7300
(714) 540-2836
(714) 540-4986
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43194
CA
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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