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Individual

AL SHYSTE MANESH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
24953 PASEO DE VALENCIA STE 13C, LAGUNA HILLS, CA 92653-4344
(949) 600-7123
(949) 364-2870
Mailing address
26800 CROWN VALLEY PARKWAY, SUITE 425, MISSION VIEJO, CA 92691
(949) 364-2935
(949) 364-2870

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
48376
CA
1223P0300X
Periodontics
Primary
48376
CA

Other

Enumeration date
04/11/2007
Last updated
11/20/2020
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