Organization
DR LIDA DAVANI DDS DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDA MOHAGHEGH-DAVANI DDS (OWNER/ PROVIDER)
(310) 410-9470
Entity
Organization
Contact information
Practice address
8540 S SEPULVEDA BLVD STE 815, LOS ANGELES, CA 90045-3808
(310) 410-9470
Mailing address
8540 S SEPULVEDA BLVD STE 815, LOS ANGELES, CA 90045-3808
(310) 410-9470
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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