Organization
MO TAHERI, D.M.D., INC.
Active
Other names
Vivid Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD TAHERI D.M.D. (PRESIDENT)
(949) 200-3150
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD, SUITE 300, COSTA MESA, CA 92627-3786
(949) 200-3150
Mailing address
1640 NEWPORT BLVD, SUITE 300, COSTA MESA, CA 92627-3786
(949) 200-3150
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
63463
CA
Other
Enumeration date
10/26/2014
Last updated
10/26/2014
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