# A MIRACLE SMILE BY DR. DEZHAM DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770775447
- **Authorized official:** DR. HASSAN DEZHAM (OWNER)
- **Authorized official phone:** (916) 441-3311

## Contact information

- **Practice address:** 2131 CAPITOL AVE, SUITE 100, SACRAMENTO, CA 95816-5755
- **Practice address phone:** (916) 441-3311
- **Practice address fax:** (916) 441-0630
- **Mailing address:** 2131 CAPITOL AVE STE 100, SACRAMENTO, CA 95816-5755
- **Mailing address phone:** (916) 441-3311
- **Mailing address fax:** (916) 441-0630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 52801 | CA | Yes |

## Other

- **Enumeration date:** 08/15/2007
- **Last updated:** 08/15/2007