Individual
SARA MASOUMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(215) 427-8783
Mailing address
1409 MIDVALE AVE APT 211, LOS ANGELES, CA 90024-1402
(424) 426-8030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39898
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/17/2023
Last updated
05/20/2024
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