Provider Demographics
NPI:1598826190
Name:PARSA, MEHRDOD ARYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEHRDOD
Middle Name:ARYA
Last Name:PARSA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 HAYNES BRIDGE RD STE #700
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8532
Mailing Address - Country:US
Mailing Address - Phone:770-663-0333
Mailing Address - Fax:678-205-0241
Practice Address - Street 1:9925 HAYNES BRIDGE RD
Practice Address - Street 2:STE #700
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8532
Practice Address - Country:US
Practice Address - Phone:770-663-0333
Practice Address - Fax:678-205-0241
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist