Individual
MUSTAFA TASHKANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
635 ALBANY STREET, BOSTON, MA 02118
(617) 358-8300
Mailing address
3920 MYSTIC VALLEY PKWY, MEDFORD, MA 02155-6912
(617) 952-9159
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DL14259
MA
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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