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Provider Information for 1932395639



DR. ALIREZA ALLEN BLOURCHIAN DDS

Gender: MALE

Individual NPI: 1932395639

Calendar Last Updated: 2007-09-18

Details

Name Value
NPI 1932395639
Enumeration Date 2007-09-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 155 COVER DRIVE SUITE 300
FRANKLIN, TN 37067
United States

Phone: 615-591-4490 | Fax: 615-591-4412
View Map External Link
Primary Practice Address 155 COVER DRIVE SUITE 300
FRANKLIN, TN 37067
United States

Phone: 615-591-4490 | Fax: 615-591-4412
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist TN DS5340
Other Identifiers
Issuer State Number
Other STATE OF TENNESSEE TN DS5340
MEDICAID TN 3206940
Other DEA BB2768856