Individual
AZITA MOGHADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3009 K ST # 255, SACRAMENTO, CA 95816-5223
(916) 447-2717
Mailing address
319 SPRIG CIR, FOLSOM, CA 95630-8578
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
47292
CA
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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