Individual
DR. ALI-REZA ETEMADIEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
665 N TUSTIN ST STE W, ORANGE, CA 92867-7148
(714) 628-9910
Mailing address
665 N TUSTIN ST STE W, ORANGE, CA 92867-7148
(714) 628-9910
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61311
CA
Other
Enumeration date
11/08/2012
Last updated
04/22/2015
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