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Organization
GRAND PRAIRIE FAMILY DENTAL GROUP
Active
Organization
GRAND PRAIRIE FAMILY DENTAL GROUP
Active
Other names
Grand Prairie Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEHROOZ KHADEMAZAD DDS (OWNER)
(972) 988-0900
Entity
Organization
Contact information
Practice address
2475 W PIONEER PKWY, GRAND PRAIRIE, TX 75051-3527
(972) 988-0900
(972) 660-1167
Mailing address
2475 W PIONEER PKWY, GRAND PRAIRIE, TX 75051-3527
(972) 988-0900
(972) 660-1167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15515
TX
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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