Provider Demographics
NPI:1588844534
Name:ALEAGHA, NASIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:NASIM
Middle Name:
Last Name:ALEAGHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NASIM
Other - Middle Name:
Other - Last Name:ARZEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:108 N 11TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3264
Mailing Address - Country:US
Mailing Address - Phone:406-587-5437
Mailing Address - Fax:
Practice Address - Street 1:108 N 11TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3264
Practice Address - Country:US
Practice Address - Phone:406-587-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX250441223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry