Organization
EDALAT DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOSSEIN EDALAT DDS (ENDODONTIST-OWNER)
(310) 999-8777
Entity
Organization
Contact information
Practice address
130 AVENIDA CABRILLO STE B, SAN CLEMENTE, CA 92672-5509
(949) 409-4080
(949) 284-9200
Mailing address
18625 BROOKHURST ST, FOUNTAIN VALLEY, CA 92708-6748
(949) 409-4080
(949) 284-9200
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
08/30/2019
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