Provider Demographics
NPI:1235802497
Name:AMAR MAHDI DENTAL INC
Entity Type:Organization
Organization Name:AMAR MAHDI DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-615-4998
Mailing Address - Street 1:3025 BEARDSLEY WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2533
Mailing Address - Country:US
Mailing Address - Phone:505-615-4998
Mailing Address - Fax:
Practice Address - Street 1:9141 E STOCKTON BLVD STE 230
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9502
Practice Address - Country:US
Practice Address - Phone:505-615-4998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental