Individual
DR. MEHRDAD FATHIAN-DEHKORDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
100 E NEWTON ST RM 104C, BOSTON, MA 02118-2308
(617) 638-4852
Mailing address
45 E NEWTON ST APT 120, BOSTON, MA 02118-4803
(617) 990-4037
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10292
MA
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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