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Organization

ALI MODIRI DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALI MODIRI DENTIST (PRESIDENT)
(917) 658-5823
Entity
Organization

Contact information

Practice address
44 STRAWBERRY HILL AVE, SUITE 1, STAMFORD, CT 06902-2632
(203) 504-5870
Mailing address
420 E 64TH ST APT W3F, NEW YORK, NY 10065-7862
(917) 658-5823

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050220
NY

Other

Enumeration date
04/21/2011
Last updated
01/12/2012
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