Mehrdad Soheilimoghadam

NPI #1124414867 in North Wales, Pennsylvania

Provider Information

NPI Number: 1124414867
Entity Type: Individual
Name: Mehrdad Soheilimoghadam
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Periodontics
Enumeration Date: Apr 9, 2015
Last Updated: Apr 9, 2015

Practice Location

Address: 132 WILDER WAY
City: North Wales
State: Pennsylvania
ZIP Code: 19454-1532
Phone: (310) 760-6042

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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