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General NPI Number Information
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NPI Number | 1952766297
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Entity Type | Individual
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Provider Name | AMAR MAHDI DDS
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Gender | Male
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 08/16/2021
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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 | 916-686-8989
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Fax |
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Provider Business Mailing Address
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Address Line | 9450 FAIRWAY DR STE 110
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City | ROSEVILLE
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State | CA
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Zip | 95678-3588
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 65319
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License Number State | CA
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