| NPI | 1205719531 |
|---|---|
| Doing Business As | DC DENTIST AT PROVIDENCE |
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD HEMMATIAN Owner 202-854-7103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |