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Individual

GELAREH ESFANDIARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
12407
MA
124Q00000X
Dental Hygienist
Primary
DH12407
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1301071
MA
Enumeration date
01/24/2007
Last updated
12/21/2011
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