Individual
BOBAK BAKHSHOUDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 TUDOR CITY PL, APT 2122, NEW YORK, NY 10017-6819
(631) 880-2208
Mailing address
308 E 38TH ST APT 6D, NEW YORK, NY 10016-9821
(631) 880-2208
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
057492-1
NY
1223E0200X
Endodontics
Primary
057492-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
05/01/2013
Last updated
06/29/2019
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