Individual
AFSANEH KADKHODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17550 COLIN'S STREET, ENCINO, CA 91316-5762
(310) 595-4605
Mailing address
1801 GIBSON BLVD SE, ALBUQUERQUE, NM 87106-3348
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60406
CA
122300000X
Dentist
Primary
DD4063
NM
Other
Enumeration date
07/05/2011
Last updated
10/29/2015
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