Individual
AFSANEH S DADSERESHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 S ELM DR APT 203, LOS ANGELES, CA 90035-1132
(323) 568-9593
Mailing address
1115 S ELM DR APT 203, LOS ANGELES, CA 90035-1132
(323) 568-9593
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
18833
CA
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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