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Organization

A MIRACLE SMILE BY DR. DEZHAM DENTAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HASSAN DEZHAM (OWNER)
(916) 441-3311
Entity
Organization

Contact information

Practice address
2131 CAPITOL AVE, SUITE 100, SACRAMENTO, CA 95816-5755
(916) 441-3311
(916) 441-0630
Mailing address
2131 CAPITOL AVE STE 100, SACRAMENTO, CA 95816-5755
(916) 441-3311
(916) 441-0630

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
52801
CA

Other

Enumeration date
08/15/2007
Last updated
08/15/2007
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