Individual
OMID MEHDIPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7900 OLD YORK RD, #108A, ELKINS PARK, PA 19027-2318
(215) 635-0808
Mailing address
901 NORTH PENN STREET, R-2101, PHILADELPHIA, PA 19123
(202) 758-9707
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS039086
PA
Other
Enumeration date
05/19/2008
Last updated
12/29/2015
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