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MANDANA MOZAYENI-AZAR D.D.S., M.S.D.

>> Dentist >> Dental Providers

Registrant NPI Number: 1912970724

Individual Registrant:
 MANDANA  MOZAYENI-AZAR D.D.S., M.S.D.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
18 COASTAL OAK  NEWPORT COAST, CA 92657-1655 US
Tel: 216-299-5223  Fax: --

Contact information for business:
3189 LANDER RD  PEPPER PIKE, OH 44124-5442 US
Tel: 330-633-7076  Fax: 216-378-8964

Registration Information:
NPI: 1912970724
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N122300000XDental Providers
Dentist
CA49379
N1223X0400XDental Providers
Dentist
OH21664
Y1223X0400XDental Providers
Dentist
CA49379

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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