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General NPI Number Information
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NPI Number | 1265923049
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Entity Type | Individual
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Provider Name | MINA ARBABARAGHI DMD
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Gender | Female
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 3608 DALE RD
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City | MODESTO
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State | CA
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Zip | 95356-0500
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Country | US
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Telephone | 209-577-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 3633 DEER TRAIL DR
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City | DANVILLE
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State | CA
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Zip | 94506-6021
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Country | US
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Telephone | 925-451-5708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 102439
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License Number State | CA
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