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General NPI Number Information
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NPI Number | 1447701081
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Entity Type | Organization
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Legal Business Name | MHB2-PLLC
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 4731 E LANCASTER AVE
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City | FORT WORTH
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State | TX
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Zip | 76103-3835
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Country | US
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Telephone | 817-531-0431
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Fax | 817-531-2389
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Provider Business Mailing Address
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Address Line | 3805 SPRINGBRANCH DR
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City | BENBROOK
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State | TX
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Zip | 76116-7631
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Country | US
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Telephone | 310-702-8678
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SALOMEH TEHRANI
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Credential | DDS
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Telephone | 310-702-8678
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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 | 26254
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License Number State | TX
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