Provider Demographics
NPI:1235361163
Name:DR KAMRAN GHOREYSHI A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:DR KAMRAN GHOREYSHI A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:QUALITY FAMILY DENTAL & COSMETIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOREYSHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-461-8660
Mailing Address - Street 1:38605 CALISTOGA DR STE C3
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4882
Mailing Address - Country:US
Mailing Address - Phone:951-461-8660
Mailing Address - Fax:760-357-9009
Practice Address - Street 1:38605 CALISTOGA DR STE C3
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4882
Practice Address - Country:US
Practice Address - Phone:951-461-8660
Practice Address - Fax:760-357-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty