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General NPI Number Information
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NPI Number | 1366532012
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Entity Type | Organization
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Legal Business Name | MOSHREFI AND DANESHMAND, DDS, INC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 9735 WILSHIRE BLVD #211
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2107
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Country | US
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Telephone | 310-859-9449
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Fax | 310-859-9451
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Provider Business Mailing Address
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Address Line | 9735 WILSHIRE BLVD #211
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2107
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Country | US
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Telephone | 310-859-9449
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Fax | 310-859-9451
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Authorized Official
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Title or Position | CEO
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Name | DR. ABDOLLAH MOSHREFI
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Credential | DDS, MS
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Telephone | 310-859-9449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 46300
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License Number State | CA
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