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General NPI Number Information
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NPI Number | 1346481371
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Entity Type | Organization
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Legal Business Name | KAMYAR SAEIAN D.D.S.
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Dates
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Enumeration Date | 03/21/2009
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Last Update Date | 03/21/2009
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Provider Practice Location Address
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Address Line | 3970 N OAKLAND AVE SUITE 501
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City | SHOREWOOD
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State | WI
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Zip | 53211-2265
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Country | US
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Telephone | 414-967-0993
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Fax | 414-967-0993
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Provider Business Mailing Address
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Address Line | 3970 N OAKLAND AVE SUITE 501
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City | SHOREWOOD
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State | WI
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Zip | 53211-2265
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Country | US
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Telephone | 414-967-0993
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Fax | 414-967-0993
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Authorized Official
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Title or Position | DENTIST
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Name | MR. KAMYAR SAEIAN
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Credential | D.D.S.
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Telephone | 262-642-5119
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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 | 3666
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License Number State | WI
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