Individual
DR. MAHDI TAEBI-HARANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1046 WESTERN AVE, BRATTLEBORO, VT 05301-7144
(802) 230-0194
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06032-1956
(860) 679-2000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1859198
MA
390200000X
Student in an Organized Health Care Education/Training Program
12515
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103234
—
CA
Enumeration date
09/14/2018
Last updated
01/24/2022
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