| Diba Dastjerdi | |
|
62 Burrill St Swampscott MA 01907-1903 | |
| (781) 599-4505 | |
| (781) 599-4945 |
| Full Name | Diba Dastjerdi |
|---|---|
| Speciality | Dentist |
| Location | 62 Burrill St, Swampscott, Massachusetts |
| Authorized Official Name and Position | Diba Dastjerdi (INDEPENDANT CONTRACTOR/DENTIST) |
| Authorized Official Contact | 7815994505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diba Dastjerdi 62 Burrill St Swampscott MA 01907-1903 Ph: (781) 599-4505 | Diba Dastjerdi 62 Burrill St Swampscott MA 01907-1903 Ph: (781) 599-4505 |
| NPI Number | 1326299702 |
|---|---|
| Provider Enumeration Date | 10/03/2008 |
| Last Update Date | 01/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326299702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21835 (Massachusetts) | Primary |
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