Organization
SHAHNAZ BONYANPOOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHNAZ BONYANPOOR (OWNER DOCTOR)
(949) 252-9950
Entity
Organization
Contact information
Practice address
62 CORPORATE PARK, SUITE 135, IRVINE, CA 92606-3122
(949) 252-9950
Mailing address
62 CORPORATE PARK, SUITE 135, IRVINE, CA 92606-3122
(949) 252-9950
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9298501
DENTICAL
CA
Enumeration date
08/23/2007
Last updated
08/23/2007
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