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Organization
DELDENTAL GROUP
Active
Organization
DELDENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRZAD Z FATTAHI DDS (OWNER)
(310) 822-8118
Entity
Organization
Contact information
Practice address
8035 W MANCHESTER AVE STE B, PLAYA DEL REY, CA 90293-7985
(310) 822-8118
(310) 821-9276
Mailing address
8035 W MANCHESTER AVE STE B, PLAYA DEL REY, CA 90293-7985
(310) 822-8118
(310) 821-9276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41913
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447320338
—
CA
Enumeration date
03/26/2008
Last updated
03/26/2008
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