Organization
FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI KHAKSARFARD D.D.S. (CEO)
(740) 333-7290
Entity
Organization
Contact information
Practice address
1387 LEESBURG AVE, WASHINGTON COURT HOUSE, OH 43160-8655
(740) 333-7290
(740) 333-7291
Mailing address
1387 LEESBURG AVE, WASHINGTON COURT HOUSE, OH 43160-8655
(740) 333-7290
(740) 333-7291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21821
OH
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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