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Individual
DR. TIRBOD TODD FATTAHI
Active
Individual
DR. TIRBOD TODD FATTAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. , DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DTP368
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME85119
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947339C
—
GA
05
—
0752941-00
—
FL
05
—
2644371-00
—
FL
Enumeration date
02/18/2006
Last updated
04/29/2008
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