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General NPI Number Information
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NPI Number | 1265176952
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Entity Type | Organization
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Legal Business Name | ALIGN DENTAL CORP
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 851 S STATE ROAD 434 STE 1040
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-4812
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Country | US
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Telephone | 407-603-2344
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 PARK ST STE 106
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City | NAPERVILLE
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State | IL
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Zip | 60563-2609
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Country | US
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Telephone | 407-603-2344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMAD MOEIN AZIMI
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Credential |
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Telephone | 630-999-9637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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