Individual
MARZIYEH KHODABAKHSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 ROCKBOURNE RD STE 400, CLIFTON HEIGHTS, PA 19018-1739
(484) 461-0128
Mailing address
4 ROCKBOURNE RD STE 400, CLIFTON HEIGHTS, PA 19018-1739
(484) 461-0128
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041884
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DS041884
—
PA
Enumeration date
07/27/2018
Last updated
07/27/2018
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