Organization
FAMILY DENTAL CARE AT EAGLETON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI KHAKSAFARD DDS (OWNER)
(740) 852-7741
Entity
Organization
Contact information
Practice address
391 LAFAYETTE ST., LONDON, OH 43140-9195
(740) 852-7741
(740) 852-7783
Mailing address
391 LAFAYETTE ST, LONDON, OH 43140-9326
(740) 852-7741
(740) 852-7783
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2007
Last updated
03/30/2017
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