Organization
DIBA DASTAJERDI DMD PC
Active
Other names
Carr & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIBA DASTAJERDI DMD (OWNER)
(617) 262-5880
Entity
Organization
Contact information
Practice address
68 NEW EDGERLY RD, BOSTON, MA 02115-3503
(617) 262-5880
(617) 859-8804
Mailing address
68 NEW EDGERLY RD, BOSTON, MA 02115-3503
(617) 262-5880
(617) 859-8804
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21835
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074397A
—
MA
Enumeration date
09/16/2014
Last updated
09/16/2014
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