Individual
AVA MANOOCHEHRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
370 CODDINGTOWN CTR, SANTA ROSA, CA 95401-3507
(707) 867-1310
Mailing address
12 WILD ROSE PL, ALISO VIEJO, CA 92656-7058
(949) 338-6015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
109221
CA
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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