Organization
COHEN SEDGH, MANAVI & PAKRAVAN DENTAL CORPORATION
Active
Other names
WEST COAST DENTAL GROUP OF RIALTO
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (Q/A CONTRACT & COMPLIANCE MANAGER)
(310) 409-4225
Entity
Organization
Contact information
Practice address
1315 RENAISSANCE PKWY STE 870, RIALTO, CA 92376-2406
(310) 820-9933
(310) 820-0408
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
(310) 820-0408
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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