Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | D5933 | AZ |
NPI | 1003878216 |
---|---|
Provider Name | Jafar Naghshbandi |
First Address | Phoenix, AZ 85022 |
Second Address | Phoenix, AZ 85022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 08/07/2007 |