Provider Demographics
NPI:1184069122
Name:HOURI FATOURACHI, DDS INC
Entity type:Organization
Organization Name:HOURI FATOURACHI, DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOURI
Authorized Official - Middle Name:
Authorized Official - Last Name:FATOURACHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-734-4400
Mailing Address - Street 1:2325 S MELROSE DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-8788
Mailing Address - Country:US
Mailing Address - Phone:760-734-4400
Mailing Address - Fax:760-734-4454
Practice Address - Street 1:2325 S MELROSE DR.
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081
Practice Address - Country:US
Practice Address - Phone:760-734-4400
Practice Address - Fax:760-734-4454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty