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Organization

AZITA S. EBRAHIMI DDS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AZITA SHEILA EBRAHIMI DDS (OWNER, PRESIDENT)
(949) 276-2990
Entity
Organization

Contact information

Practice address
25662 CROWN VALLEY PKWY STE H4, LADERA RANCH, CA 92694-0486
(949) 276-2990
Mailing address
25662 CROWN VALLEY PKWY STE H4, LADERA RANCH, CA 92694-0486
(949) 276-2990

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
52505
CA

Other

Enumeration date
01/12/2010
Last updated
01/12/2010
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