Organization
REZA MOVAHED DMD, LLC
Active
Organization
REZA MOVAHED DMD, LLC
Active
Other names
Mid America Oral Surgery and Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
REZA MOVAHED DMD (OWNER)
(618) 206-2630
Entity
Organization
Contact information
Practice address
624 PIERCE BLVD STE 200, O FALLON, IL 62269-2582
(618) 206-2630
(618) 206-2631
Mailing address
220 ADMIRAL TROST RD STE B, COLUMBIA, IL 62236-2163
(618) 344-3456
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
07/20/2017
Last updated
01/24/2023
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