Individual
DR. NIMA MIRMOGHTADAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1025 N 63RD ST APT E39, LINCOLN, NE 68505-2204
(213) 948-7004
Mailing address
1025 N 63RD ST APT E39, LINCOLN, NE 68505-2204
(213) 948-7004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
100
NE
122300000X
Dentist
Primary
60743
CA
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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