Individual
MANDANA ETEMAD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
6120 MAGAZINE ST, NEW ORLEANS, LA 70118-5826
(504) 891-7471
(504) 891-8919
Mailing address
6120 MAGAZINE ST, NEW ORLEANS, LA 70118-5826
(504) 891-7471
(504) 891-8919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5458
LA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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