Individual
DR. FERESHTEH P TABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
12420 SAN JOSE BLVD, SUITE ONE, JACKSONVILLE, FL 32223-2643
(904) 268-3002
(904) 880-5669
Mailing address
12420 SAN JOSE BLVD, SUITE ONE, JACKSONVILLE, FL 32223-2643
(904) 268-3002
(904) 880-5669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12039
FL
Other
Enumeration date
07/23/2006
Last updated
07/08/2007
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