# ALICIA PKWY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598168759
- **Authorized official:** MATT G FARZIN DDS (OWNER)
- **Authorized official phone:** (949) 587-3010

## Contact information

- **Practice address:** 25401 ALICIA PKWY STE J, LAGUNA HILLS, CA 92653-4958
- **Practice address phone:** (949) 587-3010
- **Practice address fax:** (949) 215-3757
- **Mailing address:** 25401 ALICIA PKWY STE J, LAGUNA HILLS, CA 92653-4958
- **Mailing address phone:** (949) 587-3010
- **Mailing address fax:** (949) 215-3757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 53595 | CA | Yes |

## Other

- **Enumeration date:** 10/02/2014
- **Last updated:** 10/02/2014