Diba Dastjerdi

NPI #1326299702 in Swampscott, Massachusetts

Provider Information

NPI Number: 1326299702
Entity Type: Organization
Organization Name: Diba Dastjerdi
Primary Specialty: Dentist
Enumeration Date: Oct 3, 2008
Last Updated: Jan 6, 2009

Practice Location

Address: 62 BURRILL ST
City: Swampscott
State: Massachusetts
ZIP Code: 01907-1903
Phone: (781) 599-4505

Authorized Official

Name: DIBA DASTJERDI, D.M.D
Title: INDEPENDANT CONTRACTOR/DENTIST
Phone: (781) 599-4505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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