Individual
DR. MASSOUD EFTEKHARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
830 S MAIN ST STE 1D, COTTONWOOD, AZ 86326-4621
(602) 430-8462
(928) 634-1363
Mailing address
14524 N 106TH PL, SCOTTSDALE, AZ 85255-8595
(602) 430-8462
(928) 634-1363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4954
AZ
1223G0001X
General Practice Dentistry
Primary
4954
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4954
DENTIST LICENSE
AZ
05
—
496932
—
AZ
Enumeration date
11/03/2008
Last updated
03/17/2018
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