Organization
ROOZBEH KHOSRAVI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROOZBEH KHOSRAVI DMD, PHD (OWNER)
(617) 466-9090
Entity
Organization
Contact information
Practice address
3555 MCKINLEY AVE, TACOMA, WA 98404-2162
(617) 466-9090
Mailing address
5101 NE 55TH ST, 304, SEATTLE, WA 98105-2868
(617) 466-9090
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE60504324
WA
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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