Organization
NILOOFAR DEYHIM DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NILOOFAR DEYHIM DDS (DDS)
(408) 608-8012
Entity
Organization
Contact information
Practice address
1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
(209) 522-9963
Mailing address
3550 ALDEN WAY APT 15, SAN JOSE, CA 95117-1569
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
11/14/2017
Last updated
02/22/2019
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