Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 18186 | MA |
NPI | 1154545168 |
---|---|
Provider Name | Dr. Taraneh Naghieh |
First Address | Brookline, MA 02446-5246 |
Second Address | Boston, MA 02116-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |