Organization
GP DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GOLBARG POURKHOMAMI (DENTIST)
(602) 944-7199
Entity
Organization
Contact information
Practice address
10240 N 31ST AVE STE 100, PHOENIX, AZ 85051-9564
(602) 944-7199
Mailing address
10240 N 31ST AVE STE 100, PHOENIX, AZ 85051-9564
(602) 944-7199
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6008
AZ
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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