Healthcare Provider Details

I. General information

NPI: 1740197193
Provider Name (Legal Business Name): SEACOVE DENTAL ORACLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3922 N ORACLE RD
TUCSON AZ
85705-3276
US

IV. Provider business mailing address

3922 N ORACLE RD
TUCSON AZ
85705-3276
US

V. Phone/Fax

Practice location:
  • Phone: 520-353-1235
  • Fax: 520-306-5235
Mailing address:
  • Phone: 520-353-1235
  • Fax: 520-306-5235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: KOUSHAN AZAD
Title or Position: PRESIDENT
Credential: DMD
Phone: 520-353-1235