Organization
MARYAM BAKHTIYARI, D.D.S PROFESSIONAL DENTAL CORP
Active
Other names
manhattan beach orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
AICHA BAYROUK (INSURANCE BILLER)
(310) 372-6600
Entity
Organization
Contact information
Practice address
1117 2ND ST, MANHATTAN BEACH, CA 90266-6834
(310) 372-6600
(310) 372-4290
Mailing address
1117 2ND ST, MANHATTAN BEACH, CA 90266-6834
(310) 372-6600
(310) 372-4290
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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