Individual
ALIREZA BESHARATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
319 LYNNWAY, LYNN, MA 01901-1811
(781) 599-5437
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 583-1800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21376
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0204994
—
MA
Enumeration date
01/05/2007
Last updated
07/09/2007
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