Individual
AMIRALI HEDAYATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 E 24TH ST, NEW YORK, NY 10010-4020
(646) 520-6572
Mailing address
10 WATERSIDE PLZ APT 24F, NEW YORK, NY 10010-2606
(646) 520-6572
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN2000294
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2023
Last updated
08/01/2023
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