Individual
DR. KAMBIZ VATANDOOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
234 E 149TH ST, BRONX, NY 10451-5504
(718) 579-5690
Mailing address
75 W END AVE APT P8D, NEW YORK, NY 10023-7871
(646) 709-3910
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
061129-01
NY
Other
Enumeration date
06/25/2019
Last updated
05/16/2024
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