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Organization
KOUSHAN AZAD DENTAL DMD CORPORATION
Active
Organization
KOUSHAN AZAD DENTAL DMD CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOUSHAN AZAD DMD (PRESIDENT)
(805) 202-4988
Entity
Organization
Contact information
Practice address
426 BARCELLUS AVE STE 104, SANTA MARIA, CA 93454-6926
(805) 357-4725
Mailing address
1009 N H ST STE P, LOMPOC, CA 93436-8141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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