| Roya Mirkhan,dmd,msd,inc. | |
|
12395 El Camino Real Suite Number 314 San Diego CA 92130-3082 | |
| (858) 337-6264 | |
| (858) 755-6260 |
| Full Name | Roya Mirkhan,dmd,msd,inc. |
|---|---|
| Speciality | Dentist |
| Location | 12395 El Camino Real, San Diego, California |
| Authorized Official Name and Position | Roya Nazila Mirkhan (PRESIDENT) |
| Authorized Official Contact | 8583376264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roya Mirkhan,dmd,msd,inc. 12395 El Camino Real Suite Number 314 San Diego CA 92130 Ph: (858) 337-6264 | Roya Mirkhan,dmd,msd,inc. 12395 El Camino Real Suite Number 314 San Diego CA 92130-3082 Ph: (858) 337-6264 |
| NPI Number | 1003299892 |
|---|---|
| Provider Enumeration Date | 06/30/2015 |
| Last Update Date | 06/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003299892 | NPI | - | NPPES |
| 1396866000 | Other | CA | DENTISTRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 44743 (California) | Primary |
| 1223P0300X | Dentist - Periodontics | 44743 (California) | Secondary |
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