Azizi, Khosrow Benjamin

Azizi, Khosrow Benjamin is an sole proprietor health care provider with primary practice located at 242 N Keswick Ave , Glenside PA 19038-4804. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Azizi, Khosrow Benjamin can be contacted via phone (215) 576-6414.

Contact Information

Primary practice address
242 N Keswick Ave Glenside PA 19038-4804
Phone: (215) 576-6414
Fax: (215) 576-8497
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DS025908L Pennsylvania

Profile Details

NPI number 1881744563
LBN Legal business name Azizi, Khosrow Benjamin
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 12th, 2007
Last updated Dec 17th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881744563 NPPES
Pennsylvania Other 505604 UNITED CONCORDIA ID NUMBE

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