Individual
DR. MARJAN MOGHADAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
726 BROADWAY STE 350, NEW YORK, NY 10003-9502
(212) 443-1300
Mailing address
420 E 64TH ST APT W3F, NEW YORK, NY 10065-7862
(917) 658-5863
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
050158
NY
Other
Enumeration date
01/09/2007
Last updated
09/15/2010
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