Organization
FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI KHAKSARFARD DDS (OWNER/DOCTOR)
(740) 852-7741
Entity
Organization
Contact information
Practice address
1866 E US HIGHWAY 36, URBANA, OH 43078-9600
(937) 484-5775
(937) 484-5771
Mailing address
1866 E. US 36, URBANA, OH 43140
(937) 484-5775
(937) 484-5771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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