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Organization
WEST TEXAS DENTAL
Active
Organization
WEST TEXAS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOSSAIN DEZHAM (CEO)
(916) 716-8311
Entity
Organization
Contact information
Practice address
5422 RIVER OAKS BLVD, RIVER OAKS, TX 76114-3349
(716) 984-8585
Mailing address
5422 RIVER OAKS BLVD, RIVER OAKS, TX 76114-3349
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19711
TX
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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