Pantea Tavakoli-khazraee DDS

NPI 1033229091 - Dentist - 122300000X

NPI Details
NPI 1033229091
Gender Female
Enumeration Date 08/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
900 N SWALLOW TAIL DR
SUITE 103
PORT ORANGE FL, 32129, US
Phone (386) 788-5000
Fax (386) 788-5001
Business Location
900 N SWALLOW TAIL DR
SUITE 103
PORT ORANGE FL, 32129, US
Phone (386) 788-5000
Fax (386) 788-5001
Toxanomy
Taxonomy Code 122300000X
License State Florida
License Number DN13936
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According to our database, Dr. Pantea Tavakoli-khazraee DDS NPI is 1033229091, taxonomy code is 122300000X and license number is DN13936, license state is located at Florida. Pantea Tavakoli-khazraee DDS physically located at 900 N Swallow Tail Dr, Port Orange FL, 32129. NPI Number Pantea Tavakoli-khazraee DDS has the Individual type.

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1033229091 NPI number is provided on an as is basis without warranty of any kind. 1033229091 is maintained by the National Plan & Provider Enumeration System. The contents of Pantea Tavakoli-khazraee DDS are for informational purposes only.