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Individual

ROXANA IMANIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1971 MCCULLOCH BLVD N STE 100, LAKE HAVASU CITY, AZ 86403-6118
(928) 733-6070
Mailing address
777 HARRAH WAY APT 110, LAKE HAVASU CITY, AZ 86403-0813

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011078
AZ

Other

Enumeration date
06/24/2021
Last updated
06/24/2021
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