Provider Demographics
NPI:1831703479
Name:SEVILLE DENTAL GROUP, INC.
Entity type:Organization
Organization Name:SEVILLE DENTAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARSH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-582-6938
Mailing Address - Street 1:7705 SEVILLE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6570
Mailing Address - Country:US
Mailing Address - Phone:323-582-6938
Mailing Address - Fax:310-388-1088
Practice Address - Street 1:7705 SEVILLE AVE STE A
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6570
Practice Address - Country:US
Practice Address - Phone:323-582-6938
Practice Address - Fax:310-388-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty