Organization
DARAIE DENTAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVEH TOM DARAIE (OFFICER)
(310) 616-6816
Entity
Organization
Contact information
Practice address
5620 WILBUR AVENUE STE 300, TARZANA, CA 91356
(310) 616-6816
(818) 708-1396
Mailing address
5620 WILBUR AVENUE STE 300, TARZANA, CA 91356
(310) 616-6816
(818) 708-1396
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/31/2018
Last updated
12/31/2018
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