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Organization

FAMILY DENTAL CARE IN MARYSVILLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALI KHAKSARFARD (OWNER)
(740) 852-7741
Entity
Organization

Contact information

Practice address
11580 US RT 36 E, MARYSVILLE, OH 43040-8512
(740) 852-7741
Mailing address
11580 US RT 36 E, MARYSVILLE, OH 43040-8512

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
09/14/2016
Last updated
10/11/2016
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