Individual
HYKAL R KHOSRAVIBABADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1508 N RIVERSIDE DR, ESPANOLA, NM 87532-2064
(505) 753-0544
Mailing address
1985 E GLENOAKS BLVD, GLENDALE, CA 91206-2930
(818) 699-3884
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD5656
NM
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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