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General NPI Number Information
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NPI Number | 1972764959
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Entity Type | Organization
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Legal Business Name | LOTFI DDS, INC.
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 4533 STEVENS CREEK BLVD
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City | SANTA CLARA
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State | CA
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Zip | 95051-6856
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Country | US
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Telephone | 408-345-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 732 SYLVAN WAY
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City | EMERALD HILLS
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State | CA
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Zip | 94062-3900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MEHRNEGAR LOTFI
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Credential |
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Telephone | 650-455-4570
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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 | 54282
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License Number State | CA
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