Organization
SUPREME DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMADREZA GHORBANIPARVAR DDS (MEMBER)
(203) 348-5612
Entity
Organization
Contact information
Practice address
44 STRAWBERRY HILL AVE STE 9, STAMFORD, CT 06902-2632
(774) 345-9799
Mailing address
44 STRAWBERRY HILL AVE STE 9, STAMFORD, CT 06902-2632
(774) 345-9799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/28/2021
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