Individual
SHANELLE HANA SHAHERY FARAHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9871 S PARKER RD UNIT 103, PARKER, CO 80134-8802
(310) 666-4327
Mailing address
1014 PAMELA DR, BEVERLY HILLS, CA 90210-2823
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
DDS104754
CA
1223P0221X
Pediatric Dentistry
Primary
DEN.00204845
CO
Other
Enumeration date
01/25/2021
Last updated
08/16/2021
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