Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X | |||
Endodontics |
1223E0200X | |||
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) | |
Orthodontics and Dentofacial Orthopedics |
1223X0400X |
| NPI # | 1144872748 |
| LBN Legal business name | ALIREZAEI DENTAL CORPORATION |
| Authorized official | KOUROSH KEIHANI - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/12/2019 |
| Last updated | 05/26/2020 - About 6 years ago |
| Identifiers | n/a |
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ALIREZAEI DENTAL CORPORATION
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