Provider Demographics
NPI:1942769518
Name:COLTON DENTAL & ORTHODONTICS DR ZAGHI DENTAL GROUP PC
Entity Type:Organization
Organization Name:COLTON DENTAL & ORTHODONTICS DR ZAGHI DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARSHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:408-396-4530
Mailing Address - Street 1:944 VIA LATA
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3918
Mailing Address - Country:US
Mailing Address - Phone:909-340-9100
Mailing Address - Fax:909-340-9600
Practice Address - Street 1:944 VIA LATA
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3918
Practice Address - Country:US
Practice Address - Phone:909-340-9100
Practice Address - Fax:909-340-9600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty