# KEYVAN JALALI D.D.S., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265876528
- **Authorized official:** DR. AMIRKEYVAN JALALI D.D.S. (DENTIST)
- **Authorized official phone:** (704) 906-8769

## Contact information

- **Practice address:** 16640 HAWFIELD WAY DRIVE, SUITE 101, CHARLOTTE, NC 28277
- **Practice address phone:** (704) 554-8860
- **Mailing address:** 16640 HAWFIELD WAY DRIVE, SUITE 101, CHARLOTTE, NC 28277
- **Mailing address phone:** (704) 554-8860

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9299 | NC | Yes |

## Other

- **Enumeration date:** 04/17/2013
- **Last updated:** 04/17/2013