Individual
DR. AZADEH MOTEKALLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
549 LUPIN ST, BELLAIRE, TX 77401-5023
(937) 554-0639
Mailing address
549 LUPIN STREET, BELLAIRE, TX 77401
(937) 554-0639
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2629
OH
1223G0001X
General Practice Dentistry
24170
TX
1223P0221X
Pediatric Dentistry
Primary
24170
TX
Other
Enumeration date
06/22/2007
Last updated
08/03/2021
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