Individual
DR. SHAHRDAD KAZERANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D, M.S.
Contact information
Practice address
3830 FORT ST, LINCOLN PARK, MI 48146-4107
(313) 383-6800
Mailing address
1909 FERN ST, ROYAL OAK, MI 48073-4185
(408) 239-6876
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901600288
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/25/2016
Last updated
12/06/2019
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