Individual
DR. MARYAM HOSSEINALI AZADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4258 BELDEN VILLAGE MALL, SPACE FC-17, CANTON, OH 44718-2504
(330) 492-4250
(330) 492-4255
Mailing address
27540 DETROIT RD 203, WESTLAKE, OH 44145-2299
(440) 835-1611
(440) 892-1622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-022247
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2618877
—
OH
Enumeration date
11/09/2006
Last updated
11/28/2015
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