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Organization
SHIVA MOHTASHAM DDS, INC
Active
Organization
SHIVA MOHTASHAM DDS, INC
Active
Other names
Shine On Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVA MOHTASHAM DDS (OWNER)
(510) 857-7544
Entity
Organization
Contact information
Practice address
1501 BOLLINGER CANYON RD STE F, SAN RAMON, CA 94583-1758
(510) 857-7544
(925) 208-1852
Mailing address
2887 FIELDVIEW TER, SAN RAMON, CA 94583-1900
(510) 857-7544
(925) 208-1852
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
51976
CA
Other
Enumeration date
10/30/2015
Last updated
10/30/2015
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