Organization
TAQAVI AND SOROUSHIAN DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. POOYA SOROOSHIAN (OFFICE MANAGER)
(925) 876-4680
Entity
Organization
Contact information
Practice address
1540 N TRACY BLVD, TRACY, CA 95376-2903
(925) 876-4680
Mailing address
1540 N TRACY BLVD, TRACY, CA 95376-2903
(925) 876-4680
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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