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General NPI Number Information
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NPI Number | 1659492718
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Entity Type | Individual
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Provider Name | MINOU KARBAKHSCH D.D.S., M.S.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 2302 SO. UNION AVE. SUITE C-22
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-752-6336
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Fax | 253-752-5655
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Provider Business Mailing Address
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Address Line | 2302 SO. UNION AVE. SUITE C-22
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-752-6336
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Fax | 253-752-5655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 8579
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License Number State | WA
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