Individual
DR. IDA KHOBAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
44 N 11TH AVE, CORNELIUS, OR 97113-9020
(503) 359-8505
(503) 359-8535
Mailing address
PO BOX 568, CORNELIUS, OR 97113-0568
(503) 352-8657
(503) 352-8658
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10260
OR
Other
Enumeration date
06/09/2013
Last updated
10/12/2016
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