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General NPI Number Information
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NPI Number | 1235802497
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Entity Type | Organization
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Legal Business Name | AMAR MAHDI DENTAL INC
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Dates
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Enumeration Date | 07/25/2021
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Last Update Date | 07/25/2021
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Provider Practice Location Address
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Address Line | 9141 E STOCKTON BLVD STE 230
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City | ELK GROVE
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State | CA
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Zip | 95624-9502
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Country | US
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Telephone | 505-615-4998
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Fax |
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Provider Business Mailing Address
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Address Line | 3025 BEARDSLEY WAY
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City | ROSEVILLE
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State | CA
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Zip | 95661-2533
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Country | US
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Telephone | 505-615-4998
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AMAR MAHDI
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Credential | DDS
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Telephone | 505-615-4998
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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 |
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License Number State |
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