Individual
ALI MAISAM RAHIMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8514 DEER BROOK PL, FORT WAYNE, IN 46825-6425
(260) 416-9208
Mailing address
8514 DEER BROOK PL, FORT WAYNE, IN 46825-6425
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013863A
IN
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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