Individual
HESSAM S SIAVASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
5200 TELEGRAPH RD STE B, VENTURA, CA 93003-4185
(805) 648-5121
Mailing address
5200 TELEGRAPH RD STE B, VENTURA, CA 93003-4185
(805) 648-5121
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
59781
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A124710
CA
Other
Enumeration date
02/15/2007
Last updated
04/20/2017
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