Individual
DR. POUYA HATAM-EBRAHIMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
676 DEKALB PIKE, SUITE #207, BLUE BELL, PA 19422-1223
(610) 272-4482
(610) 272-4484
Mailing address
676 DEKALB PIKE, SUITE #207, BLUE BELL, PA 19422-1223
(610) 272-4482
(610) 272-4484
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS-029503-L
PA
Other
Enumeration date
02/08/2008
Last updated
02/08/2008
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