# OFFICE OF DR. PAKRAVAN DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Campos Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871107102
- **Authorized official:** DR. ANTHONY NEEDHAM DDS (OWNER)
- **Authorized official phone:** (510) 548-3368

## Contact information

- **Practice address:** 2136 UNIVERSITY AVE, BERKELEY, CA 94704-1026
- **Practice address phone:** (510) 548-3368
- **Practice address fax:** (510) 259-2496
- **Mailing address:** 2136 UNIVERSITY AVE, BERKELEY, CA 94704-1026
- **Mailing address phone:** (510) 548-3368
- **Mailing address fax:** (510) 259-2496

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2020
- **Last updated:** 09/03/2020