Individual
MOHAMMAD REZA TABATABAI IRANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
446 S MAIN ST, NEW BRITAIN, CT 06051-3516
(860) 225-0552
Mailing address
475 MAIN ST APT 2R, NEW YORK, NY 10044-0084
(949) 300-3631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11704
CT
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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