Individual
DR. ABTIN IRANMANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7564 HIGHWAY 72 W STE C, MADISON, AL 35758-9437
(256) 690-5099
Mailing address
108 SANOMA DR, MADISON, AL 35758-1394
(615) 473-0273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D.0006698-C1
AL
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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