Organization
A MOLA DDS APC
Active
Parent organization
ALIREZA MOLA DDS INC
Other names
Select Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALIREZA MOLA DDS INC
Authorized official
DR. ALIREZA MOLA GENERAL DENTIST DDS (OWNER/PRESIDENT)
(510) 590-7297
Entity
Organization
Contact information
Practice address
1050 NORTHGATE DR STE 505, SAN RAFAEL, CA 94903-2542
(415) 499-9300
Mailing address
145 E 14TH ST # 100, SAN LEANDRO, CA 94577-1661
(510) 587-9400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
62246
CA
Other
Enumeration date
08/28/2018
Last updated
09/20/2018
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