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Individual
SIAVASH TAVAKOLI
Active
Individual
SIAVASH TAVAKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17911
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730265968
NPI NUMBER FOR ORGANIZATION
TX
Enumeration date
03/20/2014
Last updated
03/20/2014
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