Individual
SHAHIN SETOUDEHMARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14207 COIT RD STE 112, DALLAS, TX 75254-2839
(888) 676-2327
Mailing address
200 SPRING GARDEN ST UNIT 610, PHILADELPHIA, PA 19123-3839
(424) 542-4977
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
40915
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2024
Last updated
08/12/2024
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