Farzaneh, Masoud K.

Farzaneh, Masoud K. is an individual health care provider with primary practice located at 105 N Church Ave , Mulberry FL 33860-2413. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Farzaneh, Masoud K. can be contacted via phone (863) 869-8888.

Contact Information

Primary practice address
105 N Church Ave Mulberry FL 33860-2413
Phone: (863) 869-8888
Fax: (863) 869-8880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN 13817 Florida

Profile Details

NPI number 1669544540
LBN Legal business name Farzaneh, Masoud K.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Jan 14th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669544540 NPPES
Florida MEDICAID 071188800
Florida Other DN 13817

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