Individual
DR. ELINAZ SHOUSHTARI MOGHADDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
13700 MARINA POINTE DR UNIT 901, MARINA DEL REY, CA 90292-9263
(917) 623-0743
Mailing address
13700 MARINA POINTE DR UNIT 901, MARINA DEL REY, CA 90292-9263
(917) 623-0743
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
62009
CA
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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