Individual
SIAVASH DEHGHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
254 GREYLOCK PKWY APT 2, BELLEVILLE, NJ 07109-2723
(617) 462-5483
Mailing address
254 GREYLOCK PKWY APT 2, BELLEVILLE, NJ 07109-2723
(617) 462-5483
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DR02643
NJ
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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