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General NPI Number Information
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NPI Number | 1821574617
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Entity Type | Individual
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Provider Name | PARISA J KOSHA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/14/2018
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Last Update Date | 07/14/2018
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Provider Practice Location Address
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Address Line | 3000 DANVILLE BLVD
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City | ALAMO
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State | CA
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Zip | 94507-1574
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Country | US
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Telephone | 925-208-4083
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Fax |
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Provider Business Mailing Address
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Address Line | 789 APPLE TER
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City | SAN JOSE
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State | CA
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Zip | 95111-2600
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Country | US
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Telephone | 650-283-5649
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS102589
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License Number State | CA
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