Fereshteh Maghsoudy Dmd INC
Preferred Provider Organization in La Jolla, CA. Organization (NPI-2).
NPI number1124454897
StatusActive
Last updated in NPPESSep 25, 2013
Details
- NPI
- 1124454897
- Entity type
- Organization (NPI-2)
- Legal business name
- Fereshteh Maghsoudy Dmd INC
- Organization subpart
- No
- Enumeration date
- Sep 25, 2013
- Last updated
- Sep 25, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | 44022 | CA | Yes |
Other names
- La Jolla Village Dental Office (Doing Business As)
Practice location
8950 Villa La Jolla Dr Ste B207La Jolla, CA 92037-1725
Phone 858-558-3490 · Fax 858-558-3188
Mailing address
8950 Villa La Jolla Drive #b207La Jolla, CA 92037-1725
Phone 858-558-3490 · Fax 858-558-3188
Authorized official
Fereshteh Maghsoudy
Dentist/President
8585583490
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