ALIREZA NPI 1588723951

NPI Information

ALIREZA is a periodontics dentist in Poway, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. ALIREZA NPI is 1588723951. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13422 POMERADO RD STE 202
POWAY, CA
ZIP 92064-548
Phone: (858) 679-0142
Fax: (858) 679-0165

The provider's authorized official is Alireza Khansari .
The authorized official title is Periodontist and has the following contact phone number (858) 679-0142.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 2/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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