Individual
MOHAMMAD ALI MOSTAFAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
436 RIDGE MEADE DR, LEWISVILLE, TX 75067-8387
(469) 502-1722
Mailing address
436 RIDGE MEADE DR, LEWISVILLE, TX 75067-8387
(469) 502-1722
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
34617
TX
Other
Enumeration date
04/27/2019
Last updated
04/27/2019
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