Mohammad Reza Taghavi, DDS Valid NPI
Individual provider · General Practice Dentistry · Lake Forest, CA
- NPI
- 1396822003
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 43865 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-11-01
- Last updated
- 2007-07-08
Practice location
22622 Rockfield Blvd
Lake Forest, CA 92630
(949) 837-2766