Omid Khaksarfard
NPI #1780403477 in Mt Pleasant, Wisconsin
Provider Information
- NPI Number
- 1780403477
- Entity Type
- Individual
- Name
- Omid Khaksarfard
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 9, 2024
- Last Updated
- Oct 5, 2025
Practice Location
- Address
- 6035 DURAND AVE
- City
- Mt Pleasant
- State
- Wisconsin
- ZIP Code
- 53406-5049
- Phone
- (262) 270-6933
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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Organizations
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|---|---|
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