Individual
POURANG JAHANSHAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
39-05 61ST STREET, 2ND FLOOR, WOODSIDE, NY 11137
(917) 279-7713
Mailing address
286 5TH AVE, APT 4E, BROOKLYN, NY 11215
(303) 726-1699
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
053313-1
NY
Other
Enumeration date
11/27/2006
Last updated
12/26/2013
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