Daraie Dental Group INC
Dentist, General Practice in Tarzana, CA. Organization (NPI-2).
NPI number1831661966
StatusActive
Last updated in NPPESDec 31, 2018
Details
- NPI
- 1831661966
- Entity type
- Organization (NPI-2)
- Legal business name
- Daraie Dental Group INC
- Organization subpart
- No
- Enumeration date
- Dec 31, 2018
- Last updated
- Dec 31, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
5620 Wilbur Avenue Ste 300Tarzana, CA 91356
Phone 310-616-6816 · Fax 818-708-1396
Mailing address
5620 Wilbur Avenue Ste 300Tarzana, CA 91356
Phone 310-616-6816 · Fax 818-708-1396
Authorized official
Kaveh Tom Daraie
Officer
3106166816
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