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General NPI Number Information
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NPI Number | 1184293409
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Entity Type | Organization
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Legal Business Name | POOYA SOLTANZADEH, DDS, MS INC.
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Dates
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Enumeration Date | 06/21/2021
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 8101 E KAISER BLVD STE 120
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City | ANAHEIM
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State | CA
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Zip | 92808-2261
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Country | US
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Telephone | 424-603-8394
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Fax |
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Provider Business Mailing Address
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Address Line | 5545 VIA VERANO
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City | YORBA LINDA
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State | CA
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Zip | 92887-4931
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Country | US
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Telephone | 424-603-8394
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | POOYA SOLTANZADEH
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Credential | DDS, MS
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Telephone | 424-603-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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