Individual
DR. MEHRAN MEHRABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
301 S ROOSEVELT DR STE A, BEAVER DAM, WI 53916-2439
(920) 356-9711
(920) 356-9733
Mailing address
301 S ROOSEVELT DR STE A, BEAVER DAM, WI 53916-2439
(920) 356-9711
(920) 356-9733
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
20002
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6344-15
WI
208600000X
Surgery Physician
52824-20
WI
Other
Enumeration date
09/01/2006
Last updated
09/05/2025
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