Individual
DR. AYMAN GHOZLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1745 W KETTLEMAN LN, B, LODI, CA 95242-9287
(916) 337-1077
(916) 897-2567
Mailing address
10374 STATHOS DR, ELK GROVE, CA 95757-1609
(916) 337-1077
(916) 897-2567
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D46060
—
CA
Enumeration date
02/08/2007
Last updated
10/18/2010
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