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General NPI Number Information
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NPI Number | 1184013773
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Entity Type | Organization
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Legal Business Name | YEKTA RAFATY DDS, INC.
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 888 OAK GROVE AVE. SUITE #2
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City | MENLO PARK
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State | CA
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Zip | 94025
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Country | US
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Telephone | 650-325-0465
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Fax | 650-325-1431
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Provider Business Mailing Address
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Address Line | 888 OAK GROVE AVE. SUITE #2
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City | MENLO PARK
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State | CA
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Zip | 94025
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Country | US
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Telephone | 650-325-0465
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Fax | 650-325-1431
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Authorized Official
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Title or Position | OWNER PRES., CEO
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Name | DR. YEKTA B. RAFATY
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Credential | DDS.
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Telephone | 650-325-0465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39730
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License Number State | CA
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