Koroush Bassiri D.D.S., INC.
Dentist, General Practice in Costa Mesa, CA. Organization (NPI-2).
NPI number1982806089
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1982806089
- Entity type
- Organization (NPI-2)
- Legal business name
- Koroush Bassiri D.D.S., INC.
- Organization subpart
- No
- Enumeration date
- Jun 1, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 43754 | CA | Yes |
Other names
- Bright Dental Care (Doing Business As)
Practice location
320 Bristol StSuite H
Costa Mesa, CA 92626-7946
Phone 714-546-7595 · Fax 714-546-7597
Mailing address
320 Bristol StSuite H
Costa Mesa, CA 92626-7946
Phone 714-546-7595 · Fax 714-546-7597
Authorized official
Koroush Bassiri
Ceo
7145467595
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