Organization
DANDONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOUDABEH SHARAFI DMD (DENTIST)
(858) 259-5527
Entity
Organization
Contact information
Practice address
3525 DEL MAR HEIGHTS RD, SUITE 830, SAN DIEGO, CA 92130-2199
(858) 259-5527
Mailing address
3525 DEL MAR HEIGHTS RD, SUITE 830, SAN DIEGO, CA 92130-2199
(760) 291-1700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
52929
CA
1223P0221X
Pediatric Dentistry
Primary
52929
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
52929
CA
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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