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Individual

ATOSA MAHJOORY-KHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
163 HAMPTON POINT DR, SUITE 1 & 2, ST AUGUSTINE, FL 32092-3059
(904) 230-5590
(904) 230-5591
Mailing address
163 HAMPTON POINT DR, SUITE 1 & 2, ST AUGUSTINE, FL 32092-3059
(904) 230-5590
(904) 230-5591

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 14201
FL

Other

Enumeration date
05/02/2007
Last updated
05/05/2008
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