Individual
DR. AIDA SHADRAV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
714 TIVERTON AVE, LOS ANGELES, CA 90095-8361
(310) 825-9789
Mailing address
714 TIVERTON AVE, LOS ANGELES, CA 90095-8361
(310) 825-9789
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
108909
CA
1223P0221X
Pediatric Dentistry
S6-229C
NV
Other
Enumeration date
07/06/2021
Last updated
10/08/2024
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