Individual
ATHENA NASSERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1150 E ANAHEIM ST, LONG BEACH, CA 90813-3663
(562) 901-2700
Mailing address
1150 E ANAHEIM ST, LONG BEACH, CA 90813-3663
(562) 901-2700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10394
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122300000X
NPI
CO
Enumeration date
07/25/2011
Last updated
09/07/2012
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