Individual
ARDAVAN FATEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2355 OCEAN AVE, SAN FRANCISCO, CA 94127-2600
(415) 333-1173
Mailing address
2355 OCEAN AVE, SAN FRANCISCO, CA 94127-2600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DL10896
MA
1223P0300X
Periodontics
00201945
CO
1223P0300X
Periodontics
Primary
60303
CA
Other
Enumeration date
05/20/2010
Last updated
09/16/2015
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