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Individual

DR. BEVAN SHOGHI FAREID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1591 EARL ST, KINGSBURG, CA 93631-2200
(559) 897-5042
Mailing address
1591 EARL ST, KINGSBURG, CA 93631-2200
(559) 897-5042

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
64702
CA

Other

Enumeration date
09/03/2015
Last updated
09/03/2015
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