Individual
DR. RAPHAEL SEPARZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
5543 AURA AVE, TARZANA, CA 91356-3005
(818) 523-6337
Mailing address
5543 AURA AVE, TARZANA, CA 91356-3005
(818) 523-6337
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
56203
CA
Other
Enumeration date
11/03/2009
Last updated
04/01/2010
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