Individual
DR. AVISHAN K NASIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
BOUTIQUE FAMILY DENTISTRY, 801 N TUSTIN AVE STE 504, SANTA ANA, CA 92705
(714) 550-0500
(714) 550-9560
Mailing address
2144 S BRISTOL ST, CHILDREN'S DENTAL GROUP, SANTA ANA, CA 92704
(949) 981-5601
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
64535
CA
Other
Enumeration date
06/08/2015
Last updated
10/25/2017
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