Organization
FAMILIA DENTAL WHEELING 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOUSHAN AZAD DMD (PERSIDENT)
(888) 988-4066
Entity
Organization
Contact information
Practice address
542 W DUNDEE RD, SUITE B, WHEELING, IL 60090-3227
(888) 988-4066
(847) 496-7202
Mailing address
2050 E ALGONQUIN RD STE 610, SCHAUMBURG, IL 60173-4166
(888) 988-4066
(847) 496-7202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/09/2011
Last updated
11/09/2011
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