Individual
MARIAM SUSANNE FALLAHZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4223A LEXINGTON ROAD, BOURBON FAMILY DENTISTRY PLLC, PARIS, KY 40361
(859) 988-0308
(859) 988-0310
Mailing address
4223A LEXINGTON ROAD, PARIS, KY 40361
(859) 988-0308
(859) 988-0310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7770
KY
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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