| Familia Dental Marion Llc | |
|
1903 S Western Ave Marion IN 46953 | |
| (888) 988-4066 | |
| (847) 496-7603 |
| Full Name | Familia Dental Marion Llc |
|---|---|
| Speciality | Dentist |
| Location | 1903 S Western Ave, Marion, Indiana |
| Authorized Official Name and Position | Koushan Azad (OWNER) |
| Authorized Official Contact | 8889884066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental Marion Llc 1903 S Western Ave Marion IN 46953 Ph: (888) 988-4066 | Familia Dental Marion Llc 1903 S Western Ave Marion IN 46953 Ph: (888) 988-4066 |
| NPI Number | 1437595022 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 05/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437595022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12011918A (Indiana) | Primary |
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