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Individual

DR. KAMRAN DASTOURY

Active
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Individual

DR. KAMRAN DASTOURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
000203543
CO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
101382
CA
261QA1903X
Ambulatory Surgical Clinic/Center
A146736
CA

Other

Enumeration date
02/28/2011
Last updated
05/05/2018
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