Individual
DR. MASOUD EGHTEDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(858) 577-4725
Mailing address
PSC 819 BOX18-328, FPO AE, SPAIN 09645
01134956823768
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4777
LA
Other
Enumeration date
02/07/2006
Last updated
02/03/2009
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