Individual
MANDANA MOZAYENI-AZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
49379
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
21664
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
49379
CA
Other
Enumeration date
02/10/2006
Last updated
01/03/2019
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