Individual
MOJGAN EBRAHIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Mailing address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7795
OK
Other
Enumeration date
10/12/2006
Last updated
09/07/2023
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