Organization
MORI KHATIBZADEH DDS INC.
Active
Other names
Blue Mountain Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MORTEZA KHATIBZAD DDS (DENTIST)
(858) 617-9051
Entity
Organization
Contact information
Practice address
6171 MISSION GORGE ROAD, SUITE #114, SAN DIEGO, CA 92120
(858) 617-9051
Mailing address
6171 MISSION GORGE RD STE 114, SAN DIEGO, CA 92120-3409
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
55489
CA
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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