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NPI Code Detail

MEDICARE: MERSIAN DENTAL, PLLC

MEDICARE: MERSIAN DENTAL, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1831601954
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERSIAN DENTAL, PLLC
Provider Business Mailing Address
First Line : 7863 CALLAGHAN RD STE 201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-2452
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7863 CALLAGHAN RD STE 201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-2452
Country : US
Telephone Number : 210-421-9365
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : NAZANIN GHAHREMANI
Credential : DDS
Telephone Number : 210-421-9365
Provider Enumeration Date : 10/30/2017
Last Update Date : 10/30/2017

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Directions to “MERSIAN DENTAL, PLLC ” Practice Location

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