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Khashayar Khodadoustan, DDS
NPI 1598505083 · on the registry since 2024
Practice
- Address
- 1126 Ives Ave N
Glencoe, MN 55336 - Phone
- (320) 864-3215
- Fax
- (320) 864-2768
- Organisation at this address
- Gwen Regnier Dmd Pllc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-05-30
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 Minnesota