Tirbod Todd Fattahi M.D. , DDS

NPI 1093780603 - Dentist - 122300000X

NPI Details
NPI 1093780603
Gender Male
Enumeration Date 02/18/2006
Last Updated 04/29/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
655 W 8TH ST
UFJP ORAL SURGERY
JACKSONVILLE FL, 32209-6511, US
Phone (904) 244-3901
Fax (904) 244-3218
Business Location
PO BOX 44008
UFJP PROVIDER ENROLLMENT
JACKSONVILLE FL, 32231-4008, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State Florida
License Number DTP368
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According to our database, Dr. Tirbod Todd Fattahi M.D. , DDS NPI is 1093780603, taxonomy code is 122300000X and license number is DTP368, license state is located at Florida. Tirbod Todd Fattahi M.D. , DDS physically located at 655 W 8th St, Jacksonville FL, 32209-6511. NPI Number Tirbod Todd Fattahi M.D. , DDS has the Individual type.

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1093780603 NPI number is provided on an as is basis without warranty of any kind. 1093780603 is maintained by the National Plan & Provider Enumeration System. The contents of Tirbod Todd Fattahi M.D. , DDS are for informational purposes only.