Individual
MITRA HEIDARI MOHAMMAD ABADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9737 AERO DR, SAN DIEGO, CA 92123-1859
(858) 336-8478
Mailing address
1331 MOUNT HOPE AVE APT 303, ROCHESTER, NY 14620-3934
(585) 309-3420
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
000105
NY
1223P0221X
Pediatric Dentistry
061530
NY
1223P0221X
Pediatric Dentistry
Primary
109911
CA
Other
Enumeration date
05/31/2017
Last updated
06/02/2024
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