Individual
BAHAREH DADRESANFAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, ENDODONTIST
Contact information
Practice address
4458 VIA PASEAR, SAN DIEGO, CA 92122-1506
(360) 448-5503
Mailing address
4458 VIA PASEAR, SAN DIEGO, CA 92122-1506
(360) 448-5503
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DE61321114
WA
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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