Provider Demographics
NPI:1902362387
Name:RADFAR SAADAT DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:RADFAR SAADAT DENTAL PARTNERSHIP
Other - Org Name:OXNARD GENTLE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-870-9652
Mailing Address - Street 1:2035 SAVIERS RD STE 3
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3656
Mailing Address - Country:US
Mailing Address - Phone:805-486-6327
Mailing Address - Fax:
Practice Address - Street 1:300 E ESPLANADE DR STE 1600
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1283
Practice Address - Country:US
Practice Address - Phone:805-486-6327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty