Individual
KOOROUSH MANSOURZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
12906 SE KENT KANGLEY RD, KENT, WA 98030-7940
(253) 361-3015
Mailing address
12906 SE KENT KANGLEY RD, KENT, WA 98030-7940
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60655131
WA
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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