Individual
AFSANEH MAZAHERI-SICHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
777 TURMAN ST., SUITE 107, SAN FERNANDO, CA 91340
(703) 244-3577
Mailing address
777 TRUMAN ST, SUITE 107, SAN FERNANDO, CA 91340-3382
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414582
VA
122300000X
Dentist
Primary
64212
CA
Other
Enumeration date
12/11/2014
Last updated
08/03/2015
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