Individual
TARANEH RAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8719 WOODLEY AVE STE B, NORTH HILLS, CA 91343-4729
(818) 830-6181
Mailing address
17072 ESCALON DR, ENCINO, CA 91436-3838
(310) 871-1571
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61843
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
61843
CA
Other
Enumeration date
08/27/2012
Last updated
07/19/2019
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