Organization
IDENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOSSAIN DEZHAM DDS (DENTIST)
(916) 425-4172
Entity
Organization
Contact information
Practice address
14902 PRESTON RD STE 401, DALLAS, TX 75254-9132
(916) 425-4172
Mailing address
14902 PRESTON RD STE 401, DALLAS, TX 75254-9132
(916) 425-4172
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19711
TX
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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