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Organization
FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION
Active
Organization
FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION
Active
Other names
MAGICLAND DENTAL GROUP OF SANTA FE SPRINGS
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (CREDENTIALING MANAGER)
(310) 409-4225
Entity
Organization
Contact information
Practice address
10639 CARMENITA RD UNIT 7, SANTA FE SPRINGS, CA 90670-4017
(310) 820-9933
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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