Individual
MRS. HOORSHAD FATHI-KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
707 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2210
(415) 514-3791
Mailing address
PO BOX 102, LIVERMORE, CA 94551-0102
(858) 291-9895
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
107062
CA
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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