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Organization
M FARSHIDPOUR DDS INC
Active
Organization
M FARSHIDPOUR DDS INC
Active
Other names
Casa Dental of Santa Ana, M Farshidpour, DDS, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY M FARSHIDPOUR DDS (TIN OWNER)
(714) 541-0837
Entity
Organization
Contact information
Practice address
1334 W 1ST ST, SANTA ANA, CA 92703-3723
(714) 541-0837
Mailing address
1334 W 1ST ST, SANTA ANA, CA 92703-3723
(714) 541-0837
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57437
DENTIST
CA
Enumeration date
02/19/2020
Last updated
06/11/2020
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