Organization
F MOFTAKHAR DDS A PROFESSIONAL CORP
Active
Other names
Bay Area Dental Specialty Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARSHAD MOFTAKHAR DDS (OWNER CEO)
(626) 246-0150
Entity
Organization
Contact information
Practice address
3301 E 12TH ST STE 163, OAKLAND, CA 94601-2939
(510) 533-1123
(510) 485-5109
Mailing address
1809 E ECKERMAN AVE, WEST COVINA, CA 91791-1112
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
04/25/2007
Last updated
07/15/2008
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