Organization
MAHMOUD MAGHSOUDLOU LLC
Active
Other names
Aria Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MANOLO CARRILLO (MANAGER)
(509) 522-2220
Entity
Organization
Contact information
Practice address
1648 PLAZA WAY, WALLA WALLA, WA 99362-4325
(509) 522-2220
(509) 522-0171
Mailing address
1648 PLAZA WAY, WALLA WALLA, WA 99362-4325
(509) 522-2220
(509) 522-0171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008971
WA
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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