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Individual

MAHDAD NASSIRI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1416 PROFESSIONAL DR STE 202, PETALUMA, CA 94954-5108
(707) 769-1162
Mailing address
1416 PROFESSIONAL DR STE 202, PETALUMA, CA 94954-5108
(707) 769-1162

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DDS100289
CA

Other

Enumeration date
07/08/2013
Last updated
09/16/2023
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