Provider Demographics
NPI:1962827311
Name:MOURADIAN DENTAL CENTER, D.D.S., P.C.
Entity Type:Organization
Organization Name:MOURADIAN DENTAL CENTER, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT.
Authorized Official - Prefix:DR
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MURAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-939-3000
Mailing Address - Street 1:32500 MOUND RD.
Mailing Address - Street 2:MOURADIAN DENTAL CENTER, D.D.S., P.C.
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092
Mailing Address - Country:US
Mailing Address - Phone:586-939-3000
Mailing Address - Fax:
Practice Address - Street 1:32500 MOUND RD.
Practice Address - Street 2:MOURADIAN DENTAL CENTER, D.D.S., P.C.
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092
Practice Address - Country:US
Practice Address - Phone:586-939-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI016371122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty