| Vivid Smiles | |
|
1640 Newport Blvd Suite 300 Costa Mesa CA 92627-3786 | |
| (949) 200-3150 | |
| Not Available |
| Full Name | Vivid Smiles |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 1640 Newport Blvd, Costa Mesa, California |
| Authorized Official Name and Position | Mohammad Taheri (PRESIDENT) |
| Authorized Official Contact | 9492003150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivid Smiles 1640 Newport Blvd Suite 300 Costa Mesa CA 92627-3786 Ph: (949) 200-3150 | Vivid Smiles 1640 Newport Blvd Suite 300 Costa Mesa CA 92627-3786 Ph: (949) 200-3150 |
| NPI Number | 1750786349 |
|---|---|
| Provider Enumeration Date | 10/26/2014 |
| Last Update Date | 10/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750786349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 63463 (California) | Primary |
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