Individual
MR. REZA TAHERNIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
8050 FREEDON LANE NE, SUITE C, LACEY, WA 98516
(360) 339-4373
(360) 915-7398
Mailing address
8050 FREEDON LANE NE, SUITE C, LACEY, WA 98516
(360) 339-4373
(360) 915-7398
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60517330
WA
Other
Enumeration date
01/02/2015
Last updated
07/24/2015
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