Organization
GOEL, COHEN & RIAZI DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN COHEN (PRESIDENT)
(310) 749-8013
Entity
Organization
Contact information
Practice address
3108 HIGHWAY 76, FALLBROOK, CA 92028-9318
(760) 723-1193
Mailing address
3108 HIGHWAY 76, FALLBROOK, CA 92028-9318
(760) 723-1193
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40423
DCA LICENSE
CA
Enumeration date
08/21/2020
Last updated
08/21/2020
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