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General NPI Number Information
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NPI Number | 1184960601
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Entity Type | Organization
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Legal Business Name | BAHAREH SABZEHEI DDS, PC
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 01/02/2013
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Provider Practice Location Address
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Address Line | 1426 CARING CT
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City | MAITLAND
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State | FL
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Zip | 32751-4252
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Country | US
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Telephone | 312-343-0568
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Fax |
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Provider Business Mailing Address
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Address Line | 515 STATE ROAD 436 SUITE #1010
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City | CASSELBERRY
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State | FL
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Zip | 32707-5341
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BAHAREH SABZEHEI
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Credential |
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Telephone | 312-343-0568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN19993
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License Number State | FL
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