Individual
DR. BIJAN MODJTAHEDI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
18109 MAGNOLIA ST, FOUNTAIN VALLEY, CA 92708-5647
(714) 962-2432
(714) 962-3752
Mailing address
18109 MAGNOLIA ST, FOUNTAIN VALLEY, CA 92708-5647
(714) 962-2432
(714) 962-3752
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
35523
CA
Other
Enumeration date
09/13/2005
Last updated
07/08/2007
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