| Koushan H. Azad Professional Dental Corporation | |
|
272 Reservation Rd Marina CA 93933-3178 | |
| (805) 242-4044 | |
| Not Available |
| Full Name | Koushan H. Azad Professional Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 272 Reservation Rd, Marina, California |
| Authorized Official Name and Position | Koushan Azad (PRESIDENT) |
| Authorized Official Contact | 8052424044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koushan H. Azad Professional Dental Corporation 272 Reservation Rd Marina CA 93933-3178 Ph: () - | Koushan H. Azad Professional Dental Corporation 272 Reservation Rd Marina CA 93933-3178 Ph: (805) 242-4044 |
| NPI Number | 1912736588 |
|---|---|
| Provider Enumeration Date | 07/31/2024 |
| Last Update Date | 07/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912736588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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