Organization
DANOUKH DENTAL CORP.
Active
Other names
My La Mirada Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMTIN KHAEF DMD (OWNER)
(949) 510-0225
Entity
Organization
Contact information
Practice address
12271 LA MIRADA BLVD STE 201, LA MIRADA, CA 90638-1336
(562) 445-3555
Mailing address
27758 SANTA MARGARITA PKWY # 382, MISSION VIEJO, CA 92691-6709
(949) 510-0225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
06/04/2019
Last updated
06/11/2019
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