Organization
MELISSA KHURASANY A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA ESMAILZADEH KHURASANY DMD (OWNER)
(949) 614-3651
Entity
Organization
Contact information
Practice address
150 W SAN JOSE AVE, CLAREMONT, CA 91711-5204
(909) 480-1705
Mailing address
5059 STILLWATER WAY, RANCHO CUCAMONGA, CA 91739-2628
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
64760
CA
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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