Individual
AHMAD REZA EDALATI SHARBAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3701 WILLIAMS BLVD STE 253, KENNER, LA 70065-3067
(504) 469-1551
Mailing address
6468 AVENUE B, NEW ORLEANS, LA 70124-2160
(916) 294-5214
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
S-113
LA
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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