MEDICARE: BABAK FIROUZI DMD

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
1	1223G0001X	General Practice Dentistry	DS-030078-L	PA

General Provider Information

NPI Number	:	1871682427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BABAK FIROUZI DMD

Provider Business Mailing Address
First Line	:	250 MOUNT LEBANON BLVD
Second Line	:	SUITE 201
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1252
Country	:	US
Telephone Number	:	412-344-7755
Fax Number	:	412-344-7798

Provider Business Practice Location Address
First Line	:	250 MOUNT LEBANON BLVD
Second Line	:	SUITE 201
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1252
Country	:	US
Telephone Number	:	412-344-7755
Fax Number	:	412-344-7798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/14/2009

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