Individual
KEYVAN NAMAZI MATTEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 EASTGATE PLZ, BELLMEAD, TX 76705-2868
(254) 799-4867
Mailing address
5705B ELEPHANT BUTTE, WACO, TX 76708-7501
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
35413
TX
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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