Individual
DR. BANAFSHEH DADGARIAN SHOUSHTARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, FAGD
Contact information
Practice address
2 CORPORATE PLAZA DR STE 175, NEWPORT BEACH, CA 92660-7949
(949) 706-6737
(949) 706-6740
Mailing address
2 CORPORATE PLAZA DR STE 175, NEWPORT BEACH, CA 92660-7949
(949) 706-6737
(949) 706-6740
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46967
CA
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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