Individual
SHAPOUR ETEMADZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.H.
Contact information
Practice address
3490 PALM AVE, SAN DIEGO, CA 92154
(619) 423-1351
(619) 423-1407
Mailing address
3490 PALM AVE, SAN DIEGO, CA 92154
(619) 423-1351
(619) 423-1407
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH 15077
CA
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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