Familia Dental Gary Pllc

NPI 1770994121 - Dentist - 1223G0001X

NPI Details
NPI 1770994121
Enumeration Date 05/19/2014
Last Updated 10/22/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name KOUSHAN KOUSHAN
Position PRESIDENT
Phone (888) 988-4066
Fax (847) 496-7603
Practice Location
1320 BROADWAY
GARY IN, 46407-1309, US
Phone (888) 988-4066
Fax (847) 496-7603
Business Location
2050 E ALGONQUIN RD
SUITE 610
SCHAUMBURG IL, 60173-4144, US
Phone (888) 988-4066
Fax (847) 496-7603
Toxanomy
Taxonomy Code 1223G0001X
License State
License Number
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According to our database, Familia Dental Gary Pllc NPI is 1770994121, taxonomy code is 1223G0001X Familia Dental Gary Pllc physically located at 1320 Broadway, Gary IN, 46407-1309. NPI Number 1033115704 has the healthcare provider type.

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1770994121 NPI number is provided on an as is basis without warranty of any kind. 1770994121 is maintained by the National Plan & Provider Enumeration System. The contents of Familia Dental Gary Pllc are for informational purposes only.