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Organization
FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION
Active
Organization
FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION
Active
Other names
WEST COAST DENTAL & ORTHODONTICS, ADULT & KIDS DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (Q/A CONTRACT & COMPLIANCE MANAGER)
(310) 409-4225
Entity
Organization
Contact information
Practice address
2015 W 1ST ST STE E, SANTA ANA, CA 92703-3504
(310) 820-9933
(310) 820-0408
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
02/02/2024
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