Organization
DR SHABNAM SOROOSHIANI DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHABNAM SOROOSHIANI DR (OWNER/DENTIST)
(818) 620-1714
Entity
Organization
Contact information
Practice address
1902 N TRACY BLVD, TRACY, CA 95376-2423
(209) 650-3677
Mailing address
1902 N TRACY BLVD, TRACY, CA 95376-2423
(209) 650-3677
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
11/03/2021
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