| 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 |