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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
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location