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General NPI Number Information
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NPI Number | 1477966067
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Entity Type | Organization
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Legal Business Name | FROOZ FATOORACHI,DDS,APC
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 1944 VIA CTR
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City | VISTA
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State | CA
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Zip | 92081-6056
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Country | US
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Telephone | 760-732-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 1944 VIA CTR
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City | VISTA
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State | CA
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Zip | 92081-6056
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Country | US
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Telephone | 760-732-3100
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ALEJANDRA HUITRON
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Credential |
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Telephone | 760-732-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 41405
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License Number State | CA
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