Individual
MR. FAROKH ASHRAFIA KHATIBLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD DDS
Contact information
Practice address
530 S MAIN STREET, ORANGE, CA 92868
(714) 571-3495
Mailing address
28044 MARGUERITE PKWY, #K, MISSION VIEJO, CA 92692
(949) 429-2783
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
51836
CA
Other
Enumeration date
04/04/2008
Last updated
04/04/2008
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