Individual
SOOLMAZ AJDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 STATE ST, SPRINGFIELD, MA 01109-4101
(413) 736-0027
Mailing address
430 W ERIE ST, STE 200, CHICAGO, IL 60654-6914
(413) 736-0027
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
62861
CA
Other
Enumeration date
12/06/2012
Last updated
01/12/2015
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