Organization
MEHDI L. GHAVAM, D.M.D. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHDI LEE GHAVAM D.M.D. (DENTIST)
(541) 890-1950
Entity
Organization
Contact information
Practice address
106 N MARKET ST, TALENT, OR 97540-0265
(541) 890-1950
(541) 512-2601
Mailing address
3200 ANDERSON CREEK RD, TALENT, OR 97540-7733
(541) 890-1950
(541) 512-2601
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8425
OR
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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