Provider Demographics
NPI:1942331392
Name:DASTOOR, SAROSH FIRDAUS (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:SAROSH
Middle Name:FIRDAUS
Last Name:DASTOOR
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12850 JONES RD
Mailing Address - Street 2:STE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070
Mailing Address - Country:US
Mailing Address - Phone:281-890-4867
Mailing Address - Fax:281-890-1386
Practice Address - Street 1:12850 JONES RD
Practice Address - Street 2:STE 104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070
Practice Address - Country:US
Practice Address - Phone:281-890-4867
Practice Address - Fax:281-890-1386
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245681223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics