| Roozbeh Khosravi | |
|
3555 Mckinley Ave Tacoma WA 98404-2162 | |
| (617) 466-9090 | |
| Not Available |
| Full Name | Roozbeh Khosravi |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3555 Mckinley Ave, Tacoma, Washington |
| Authorized Official Name and Position | Roozbeh Khosravi (OWNER) |
| Authorized Official Contact | 6174669090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roozbeh Khosravi 5101 Ne 55th St 304 Seattle WA 98105-2868 Ph: (617) 466-9090 | Roozbeh Khosravi 3555 Mckinley Ave Tacoma WA 98404-2162 Ph: (617) 466-9090 |
| NPI Number | 1538545637 |
|---|---|
| Provider Enumeration Date | 07/31/2015 |
| Last Update Date | 07/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538545637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE60504324 (Washington) | Primary |
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