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Organization
FAMILA DENTAL MARION LLC
Active
Organization
FAMILA DENTAL MARION LLC
Active
Other names
Familia Dental Marion LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KOUSHAN AZAD (OWNER)
(888) 988-4066
Entity
Organization
Contact information
Practice address
1903 S WESTERN AVE, MARION, IN 46953
(888) 988-4066
(847) 496-7603
Mailing address
1903 S WESTERN AVE, MARION, IN 46953
(888) 988-4066
(847) 496-7603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011918A
IN
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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