Organization
SHIRIN YASREBI, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRIN YASREBI DDS (DENTIST)
(863) 667-9000
Entity
Organization
Contact information
Practice address
2015 E EDGEWOOD DR, LAKELAND, FL 33803-3601
(863) 667-9000
(863) 665-4368
Mailing address
2015 E EDGEWOOD DR, LAKELAND, FL 33803-3601
(863) 667-9000
(863) 665-4368
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN12434
FL
1223P0221X
Pediatric Dentistry
DN5634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073762300
—
FL
Enumeration date
06/19/2008
Last updated
06/19/2008
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