Shahrestani Sparks Marina Dentistry, PC

NPI #1760861447 in Sparks, Nevada

Provider Information

NPI Number: 1760861447
Entity Type: Organization
Organization Name: Shahrestani Sparks Marina Dentistry, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: May 27, 2015
Last Updated: May 27, 2015

Practice Location

Address: 475 SPARKS BLVD
Address 2: SUITE 101
City: Sparks
State: Nevada
ZIP Code: 89434-9002
Phone: (775) 359-1565

Authorized Official

Name: ALI SHAHRESTANI, CYNTHIA CASTILLO
Title: CREDENTIALING ADMINISTRATOR
Phone: (714) 845-8704

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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