Organization
G. IRAVANI. DDS. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GOWHAR IRAVANI DDS (ORTHODONTIST)
(818) 493-9159
Entity
Organization
Contact information
Practice address
405 N MACLAY AVE, SAN FERNANDO, CA 91340-2445
(818) 493-9159
Mailing address
405 N MACLAY AVE, SAN FERNANDO, CA 91340-2445
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
63471
CA
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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