DR. Pouya Hatam-Ebrahimi, D.M.D.

NPI #1043498306 in Blue Bell, Pennsylvania

Provider Information

NPI Number: 1043498306
Entity Type: Individual
Name: DR. Pouya Hatam-Ebrahimi, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Periodontics
Credential: D.M.D.
Enumeration Date: Feb 8, 2008
Last Updated: Feb 8, 2008

Practice Location

Address: 676 DEKALB PIKE
Address 2: SUITE #207
City: Blue Bell
State: Pennsylvania
ZIP Code: 19422-1223
Phone: (610) 272-4482

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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