Individual
SIUNEH KHODAVERDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6801 COLDWATER CANYON AVE, NORTH HOLLYWOOD, CA 91605-5162
(818) 763-8836
Mailing address
702 E CEDAR AVE APT A, BURBANK, CA 91501-2543
(818) 257-1307
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
28840
CA
Other
Enumeration date
03/12/2015
Last updated
04/14/2015
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