Provider Demographics
NPI:1902820509
Name:KHARAZI, MEHRBOD (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEHRBOD
Middle Name:
Last Name:KHARAZI
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 1:182 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4651
Mailing Address - Country:US
Mailing Address - Phone:603-882-5455
Mailing Address - Fax:603-886-7999
Practice Address - Street 1:182 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4651
Practice Address - Country:US
Practice Address - Phone:603-882-5455
Practice Address - Fax:603-886-7999
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32461223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics