Organization
WINCHESTER DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LADAN POURMOGHADAM DDS (OWNER)
(614) 506-0740
Entity
Organization
Contact information
Practice address
6418 WINCHESTER BLVD, CANAL WINCHESTER, OH 43110-2005
(614) 834-1834
Mailing address
6418 WINCHESTER BLVD, CANAL WINCHESTER, OH 43110-2005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30018271
OH
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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