Organization
BAHMAN TEHRANI DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BAHMAN TEHRANI DDS (OWNER)
(417) 396-3602
Entity
Organization
Contact information
Practice address
1214 US HIGHWAY 60 E, REPUBLIC, MO 65738-1248
(417) 732-4700
Mailing address
2105 E HALEY ST, REPUBLIC, MO 65738-7836
(417) 396-3602
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1999139479
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942466115
—
MO
Enumeration date
05/18/2012
Last updated
05/18/2012
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