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Organization
EZ SMILE FAMILY DENTAL GROUP
Active
Organization
EZ SMILE FAMILY DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAYAM BEHRADNIA D.D.S. (PRESIDENT)
(707) 575-9595
Entity
Organization
Contact information
Practice address
4757 HOEN AVE, SANTA ROSA, CA 95405-7862
(707) 575-9595
(707) 575-5122
Mailing address
4757 HOEN AVE, SANTA ROSA, CA 95405-7862
(707) 575-9595
(707) 575-5122
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
60893
CA
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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