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General NPI Number Information
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NPI Number | 1225540180
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Entity Type | Organization
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Legal Business Name | DR FATEMEH HADJIAN D.D.S. P.A.
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 74000 COUNTRY CLUB STE B1
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City | PALM DESERT
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State | CA
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Zip | 92260
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Country | US
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Telephone | 760-568-6900
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Fax | 760-568-6914
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Provider Business Mailing Address
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Address Line | 74000 COUNTRY CLUB STE B1
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City | PALM DESERT
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State | CA
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Zip | 92260
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Country | US
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Telephone | 760-568-6900
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Fax | 760-568-6914
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Authorized Official
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Title or Position | D.D.S. P.A.
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Name | MRS. FATEMEH HADJIAN
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Credential | D.D.S. P.A.
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Telephone | 760-568-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51212
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 51212
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License Number State | CA
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