Tavakoli-Khazraee, Pantea
Tavakoli-Khazraee, Pantea is an individual health care provider with primary practice located at 900 N Swallow Tail Dr Suite 103, Port Orange FL 32129. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Tavakoli-Khazraee, Pantea can be contacted via phone (386) 788-5000.Contact Information
Primary practice address
900 N Swallow Tail Dr Suite 103
Port Orange FL 32129
Phone: (386) 788-5000
Fax: (386) 788-5001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN13936 | Florida |
Profile Details
| NPI number | 1033229091 |
|---|---|
| LBN Legal business name | Tavakoli-Khazraee, Pantea |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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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