Individual
MITRA MIRMOTAHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
684 BATTLEFIELD BLVD N STE A, CHESAPEAKE, VA 23320-5037
(757) 319-4397
Mailing address
4209 SAUNDERS TAVERN TRL UNIT B, HENRICO, VA 23233-7816
(804) 874-0440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418415
VA
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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