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Organization
KOUSHAN AZAD DMD INC
Active
Organization
KOUSHAN AZAD DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOUSHAN AZAD (PRESIDENT)
(805) 698-3017
Entity
Organization
Contact information
Practice address
238 E BETTERAVIA RD STE C, SANTA MARIA, CA 93454-7889
(805) 242-4881
Mailing address
1009 N H ST STE P, LOMPOC, CA 93436-8141
(805) 698-3017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
09/08/2020
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