Individual
AFROOZ MOGHADAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8678 19TH ST, 140, RANCHO CUCAMONGA, CA 91701-4559
(909) 257-3388
Mailing address
9763 LA JOLLA DR APT D, RANCHO CUCAMONGA, CA 91701-6120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101340
CA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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