# MAHMOUD MAGHSOUDLOU LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aria Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265848014
- **Authorized official:** MANOLO CARRILLO (MANAGER)
- **Authorized official phone:** (509) 522-2220

## Contact information

- **Practice address:** 1648 PLAZA WAY, WALLA WALLA, WA 99362-4325
- **Practice address phone:** (509) 522-2220
- **Practice address fax:** (509) 522-0171
- **Mailing address:** 1648 PLAZA WAY, WALLA WALLA, WA 99362-4325
- **Mailing address phone:** (509) 522-2220
- **Mailing address fax:** (509) 522-0171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00008971 | WA | Yes |

## Other

- **Enumeration date:** 07/01/2014
- **Last updated:** 07/01/2014