NPI | 1861613002 |
---|---|
Former Name | SASAN DADSERESHT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41072) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 3483) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2022-07-21 |