Individual
DR. SASAN MOLAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6100 WASHINGTON AVE STE F2, MOUNT PLEASANT, WI 53406-4000
(262) 999-9998
Mailing address
6100 WASHINGTON AVE STE F2, MOUNT PLEASANT, WI 53406-4000
(630) 381-8281
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019027961
IL
122300000X
Dentist
Primary
1001793
WI
122300000X
Dentist
25283
TX
122300000X
Dentist
DD3585
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100076929
—
WI
Enumeration date
06/28/2009
Last updated
06/16/2021
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