Individual
IRFAN L DASTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD PC
Contact information
Practice address
394 ELM ST, GARDNER, MA 01440-3926
(978) 632-7870
(978) 630-2601
Mailing address
50 WOOD ST, LOWELL, MA 01851-1519
(978) 441-9991
(978) 441-9996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19552
MA
Other
Enumeration date
01/25/2007
Last updated
02/06/2016
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