| Azita S. Ebrahimi Dds Inc | |
|
25662 Crown Valley Pkwy Ste H4 Ladera Ranch CA 92694-0486 | |
| (949) 276-2990 | |
| Not Available |
| Full Name | Azita S. Ebrahimi Dds Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 25662 Crown Valley Pkwy Ste H4, Ladera Ranch, California |
| Authorized Official Name and Position | Azita Sheila Ebrahimi (OWNER, PRESIDENT) |
| Authorized Official Contact | 9492762990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Azita S. Ebrahimi Dds Inc 25662 Crown Valley Pkwy Ste H4 Ladera Ranch CA 92694-0486 Ph: (949) 276-2990 | Azita S. Ebrahimi Dds Inc 25662 Crown Valley Pkwy Ste H4 Ladera Ranch CA 92694-0486 Ph: (949) 276-2990 |
| NPI Number | 1114257235 |
|---|---|
| Provider Enumeration Date | 01/12/2010 |
| Last Update Date | 01/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114257235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 52505 (California) | Primary |
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