Organization
FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI KHAKSARFARS DDS (OWNER)
(937) 323-3400
Entity
Organization
Contact information
Practice address
1240 E. MAIN ST, SPRINGFIELD, OH 45503
(937) 323-3400
(937) 323-3403
Mailing address
1240 E. MAIN ST, SPRINGFIELD, OH 45503
(937) 323-3400
(937) 323-3403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21821
OH
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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