Provider Demographics
NPI:1003907932
Name:MORSHED, MANI (DMD, DDS)
Entity Type:Individual
Prefix:DR
First Name:MANI
Middle Name:
Last Name:MORSHED
Suffix:
Gender:M
Credentials:DMD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 7TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1648
Mailing Address - Country:US
Mailing Address - Phone:310-393-9664
Mailing Address - Fax:310-458-3399
Practice Address - Street 1:1244 7TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1648
Practice Address - Country:US
Practice Address - Phone:310-393-9664
Practice Address - Fax:310-458-3399
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice