Organization
SHAHRESTANI SPARKS MARINA DENTISTRY, PC
Active
Other names
Sparks Marina Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ALI SHAHRESTANI CYNTHIA CASTILLO (CREDENTIALING ADMINISTRATOR)
(714) 845-8704
Entity
Organization
Contact information
Practice address
475 SPARKS BLVD, SUITE 101, SPARKS, NV 89434-9002
(775) 359-1565
(775) 359-1597
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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