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Koushan Azad Dental Corpopration
Dental Clinic/Center in San Luis Obispo, California
NPI 1477030351

Koushan Azad Dental Corpopration is a Dental Clinic/Center based in Hidden Hills, CA and is specialized in Dental. Koushan Azad Dental Corpopration practices in San Luis Obispo, CA. The NPI Number for Koushan Azad Dental Corpopration is 1477030351 and holds a License No. (California).

The current practice location address for Koushan Azad Dental Corpopration is 3870 Broad St Ste 1, San Luis Obispo, CA and can be reached out via phone at 630-624-5788.

Location: 3870 Broad St Ste 1, San Luis Obispo, CA, 91302-1230
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1477030351
Provider Name
Koushan Azad Dental Corpopration
Credential
Provider Entity Type
Organization
Address
3870 Broad St Ste 1, San Luis Obispo, CA, 91302-1230
Phone Number
630-624-5788
Fax Number
Provider Enumeration Date
07/24/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3870 Broad St Ste 1
City
San Luis Obispo
State
California
Zip
93401-7172
Phone Number
630-624-5788
Fax Number
person
Provider Business Mailing Address Details
Address
3870 Broad St Ste 1
City
San Luis Obispo
State
California
Zip
93401-7172
Phone Number
630-624-5788
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
()
Definition
Definition to come...
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