Individual provider · NPI-1

Irfan L Dasti, DMD PC

Dentist, General Practice · Gardner, MA

NPI number1033264163
StatusActive
Last updated in NPPESFeb 6, 2016

Details

NPI
1033264163
Entity type
Individual (NPI-1)
Name
Irfan L Dasti
Credential
DMD PC
Sex
Male
Sole proprietor
No
Enumeration date
Jan 25, 2007
Last updated
Feb 6, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice19552MAYes

Practice location

394 Elm St
Gardner, MA 01440-3926

Phone 978-632-7870 · Fax 978-630-2601

Mailing address

50 Wood St
Lowell, MA 01851-1519

Phone 978-441-9991 · Fax 978-441-9996

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