Organization
KOUSHAN AZAD DMD. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA AGUINAGA (BUSINESS COORDINATOR)
(805) 698-3017
Entity
Organization
Contact information
Practice address
238 E BETTERAVIA RD STE C, SANTA MARIA, CA 93454-7889
(805) 202-4988
Mailing address
1009 N H ST STE P, LOMPOC, CA 93436-8141
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
08/28/2020
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