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Organization
SHAHIN MAHALLATI DENTAL CORP
Active
Organization
SHAHIN MAHALLATI DENTAL CORP
Active
Other names
Smile San Clemente
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHIN MAHALLATI DDS (OWNER)
(949) 248-7772
Entity
Organization
Contact information
Practice address
653 CAMINO DE LOS MARES STE 113, SAN CLEMENTE, CA 92673-2856
(949) 248-7772
Mailing address
653 CAMINO DE LOS MARES STE 113, SAN CLEMENTE, CA 92673-2856
(949) 248-7772
(949) 248-0516
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
11/10/2021
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