Search › Washington › 122300000X
Kooroush Mansourzadeh, D.D.S
NPI 1417309790 · on the registry since 2016 · sole proprietor
Practice
- Address
- 12906 Se Kent Kangley Rd
Kent, WA 98030 - Phone
- (253) 361-3015
- Organisation at this address
- Lake Meridian Dental Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-07-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington