Individual
BARDIA SINAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3124 WILLOW CREEK RD, PRESCOTT, AZ 86301-6610
(928) 350-6226
Mailing address
3124 WILLOW CREEK RD, PRESCOTT, AZ 86301-6610
(480) 241-1374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10289
OR
Other
Enumeration date
07/14/2015
Last updated
11/19/2018
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