| Koroush Bassiri D.d.s., Inc. | |
|
320 Bristol St Suite H Costa Mesa CA 92626-7946 | |
| (714) 546-7595 | |
| (714) 546-7597 |
| Full Name | Koroush Bassiri D.d.s., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 320 Bristol St, Costa Mesa, California |
| Authorized Official Name and Position | Koroush Bassiri (CEO) |
| Authorized Official Contact | 7145467595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koroush Bassiri D.d.s., Inc. 320 Bristol St Suite H Costa Mesa CA 92626-7946 Ph: (714) 546-7595 | Koroush Bassiri D.d.s., Inc. 320 Bristol St Suite H Costa Mesa CA 92626-7946 Ph: (714) 546-7595 |
| NPI Number | 1982806089 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982806089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43754 (California) | Primary |
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