Individual
AZADEH GHAVAMNASIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18014 SHERMAN WAY APT 144, RESEDA, CA 91335-4622
(949) 241-0095
Mailing address
18014 SHERMAN WAY APT 144, RESEDA, CA 91335-4622
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS106375
CA
Other
Enumeration date
07/10/2021
Last updated
07/10/2021
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