Advanta Dental Group

NPI #1104193051 in Emeryville, California

Provider Information

NPI Number: 1104193051
Entity Type: Organization
Organization Name: Advanta Dental Group
Primary Specialty: Dentist
Enumeration Date: Nov 21, 2011
Last Updated: Nov 21, 2011

Practice Location

Address: 5915 HOLLIS ST STE A
City: Emeryville
State: California
ZIP Code: 94608-2066
Phone: (510) 596-9000

Authorized Official

Name: DR. SEPIDEH RAZAVI, D.D.S
Title: DENTIST
Phone: (510) 596-9000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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