Individual
CANDICE SHAHANDEH-RAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11764 WILMINGTON AVE, LOS ANGELES, CA 90059-2553
(310) 962-1116
Mailing address
421 N BONHILL RD, LOS ANGELES, CA 90049-2323
(310) 962-1116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
109596
CA
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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