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Individual

AMIN REZA HERAVI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
305 E CAMP WISDOM RD, DUNCANVILLE, TX 75116-2705
(972) 296-1200
Mailing address
3603 BRYAN ST, DALLAS, TX 75204-6112
(469) 226-4841

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
37405
TX

Other

Enumeration date
06/30/2021
Last updated
06/30/2021
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