Organization
DR. MASSOUD EFTEKHARI
Active
Other names
VIP Family and Sedation Dentistry, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASSOUD EFTEKHARI DDS (DENTIST/OWNER)
(602) 430-8462
Entity
Organization
Contact information
Practice address
830 S MAIN ST STE 1D, COTTONWOOD, AZ 86326-4621
(928) 634-5566
(928) 634-5566
Mailing address
14524 N 106TH PL, SCOTTSDALE, AZ 85255-8595
(602) 430-8462
(928) 634-1363
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4954
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659524692
NPI INDIVIDUAL
AZ
01
—
4954
DENTAL LICENSE
AZ
05
—
496932
—
AZ
Enumeration date
02/05/2018
Last updated
02/05/2018
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