Individual
SHEBLI MEHRAZARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, PHD
Contact information
Practice address
22 CLUB VIS, TRABUCO CANYON, CA 92679-3747
(131) 099-7089
Mailing address
22 CLUB VIS, TRABUCO CANYON, CA 92679-3747
(131) 099-7089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61732
CA
1223P0300X
Periodontics
17802
MD
1223P0300X
Periodontics
Primary
61732
CA
1223P0300X
Periodontics
DEN2000209
DC
Other
Enumeration date
07/06/2018
Last updated
05/06/2024
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