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Organization
SIAVASH DEHGHANI D.M.D. DENTAL CORP.
Active
Organization
SIAVASH DEHGHANI D.M.D. DENTAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIAVASH DEHGHANI DMD (PRESIDENT)
(617) 462-5483
Entity
Organization
Contact information
Practice address
14465 S BASCOM AVE, K, LOS GATOS, CA 95032
(408) 371-1070
Mailing address
450 SUTTER ST, 2500, SAN FRANCISCO, CA 94108-4206
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
64099
CA
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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