Individual
DR. AWA ALIZADEH GHANNAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
914 ADMIRAL CALLAGHAN LN, VALLEJO, CA 94591-3680
(707) 674-5437
Mailing address
1401 MISSION ST APT 802, SAN FRANCISCO, CA 94103-2694
(916) 420-4530
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
110597
CA
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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