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General NPI Number Information
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NPI Number | 1629213335
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Entity Type | Organization
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Legal Business Name | STARS DENTAL INC.
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 1727 E DAILY DR SUITE H
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City | CAMARILLO
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State | CA
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Zip | 93010-6202
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Country | US
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Telephone | 805-764-0222
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Fax | 805-764-0220
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Provider Business Mailing Address
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Address Line | 1727 E DAILY DR SUITE H
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City | CAMARILLO
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State | CA
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Zip | 93010-6202
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Country | US
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Telephone | 805-764-0222
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Fax | 805-764-0220
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | MS. NEDA LISA SETAREH
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Credential | DDS
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Telephone | 805-764-0222
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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 | 45407
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License Number State | CA
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