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Organization

DIBA DASTJERDI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIBA DASTJERDI D.M.D (INDEPENDANT CONTRACTOR/DENTIST)
(781) 599-4505
Entity
Organization

Contact information

Practice address
62 BURRILL ST, SWAMPSCOTT, MA 01907-1903
(781) 599-4505
(781) 599-4945
Mailing address
62 BURRILL ST, SWAMPSCOTT, MA 01907-1903
(781) 599-4505
(781) 599-4945

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21835
MA

Other

Enumeration date
10/03/2008
Last updated
01/06/2009
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