DR. Khashayar Khodadoustan, DDS

NPI #1598505083 in Glencoe, Minnesota

Provider Information

NPI Number: 1598505083
Entity Type: Individual
Name: DR. Khashayar Khodadoustan, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: May 30, 2024
Last Updated: May 30, 2024

Practice Location

Address: 1126 IVES AVE N
City: Glencoe
State: Minnesota
ZIP Code: 55336-2226
Phone: (320) 864-3215

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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