Organization
JAVAD AGHALOO DDS A PROFESSIONAL CORPORATION
Active
Other names
Southwest Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAVAD SAGE AGHALOO DDS (OWNER)
(760) 482-5505
Entity
Organization
Contact information
Practice address
1502 S LA BRUCHERIE RD, EL CENTRO, CA 92243-9495
(760) 482-5505
(760) 482-5501
Mailing address
1502 S LA BRUCHERIE RD, EL CENTRO, CA 92243-9495
(760) 482-5505
(760) 482-5501
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
51184
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245606789
DENTICAL
CA
Enumeration date
08/19/2015
Last updated
01/15/2016
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