Soudabeh Moayedghyasy, D.M.D Valid NPI
Individual provider · General Practice Dentistry · Lake Forest, CA
- NPI
- 1760629539
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 37880 (CA)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2009-01-15
- Last updated
- 2009-01-15
Practice location
22855 Lake Forest Dr, Suite B
Lake Forest, CA 92630-1656
(949) 583-1558