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General NPI Number Information
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NPI Number | 1619304268
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Entity Type | Organization
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Legal Business Name | BERWEEN MOURADY DDS PLLC
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 9362 S COLORADO BLVD UNIT D14
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-5207
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Country | US
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Telephone | 651-431-8148
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Fax |
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Provider Business Mailing Address
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Address Line | 9362 S COLORADO BLVD UNIT D14
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-5207
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Country | US
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Telephone | 651-431-8148
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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. BERWEN MOURADY
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Credential | DDS
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Telephone | 720-763-9020
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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 | D10279
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License Number State | CO
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