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F.Pakravan Dental Corporation

Organization Active NPI General Practice Dentistry · Clovis, CA

NPI 1508089889 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1508089889
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
39862 (CA)
Legal business name
F.PAKRAVAN DENTAL CORPORATION
Practice address
200 W Shaw Ave
Suite 110
Clovis, CA 93612-3684
Phone
(559) 325-6161
Fax
(559) 325-6166
NPI assigned
Apr 11, 2007
Organization subpart
No

Authorized official

Name
Farid Pakravan
Title
Owner
Phone
(559) 325-6161

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Dental Group of Clovis (2 organizations share this tax ID)

Locations

200 W Shaw Ave
Ste 110
Clovis, CA 93612
Phone (559) 325-6161

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP		 1223G0001X 39862 CA Yes

Addresses

Primary practice location

200 W Shaw Ave
Suite 110
Clovis, CA 93612-3684

Mailing address

200 W Shaw Ave
Suite 110
Clovis, CA 93612-3684
Phone (559) 325-6161

Other names

  • DENTAL GROUP OF CLOVIS Doing business as

Other providers in Clovis, CA

All providers in Clovis, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.