Individual
POUYA NAMIRANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8150 GREENBACK LN STE 300, FAIR OAKS, CA 95628-2505
(916) 723-1111
(916) 723-1112
Mailing address
141 MARBLE CANYON DR, FOLSOM, CA 95630-7112
(408) 410-1911
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DDS104423
CA
Other
Enumeration date
03/19/2019
Last updated
07/27/2023
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