Individual
KATIA MORTAZAVINIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
9221 E BASELINE RD STE 111, MESA, AZ 85209-8314
(480) 265-8702
(480) 265-8703
Mailing address
9221 E BASELINE RD STE 111, MESA, AZ 85209-8314
(480) 265-8702
(480) 265-8703
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010258
AZ
Other
Enumeration date
09/23/2010
Last updated
06/18/2019
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