Organization
DEL MAR PEDIATRIC & ADOLESCENTS DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOUDABEH SHARAFI DMD (DENTIST)
(858) 259-1400
Entity
Organization
Contact information
Practice address
12750 CARMEL COUNTRY RD STE 215, SAN DIEGO, CA 92130-2172
(858) 259-1400
(858) 259-1401
Mailing address
12750 CARMEL COUNTRY RD STE 215, SAN DIEGO, CA 92130-2172
(858) 259-1400
(858) 259-1401
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
52929
CA
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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