Dr. Khosrow Benjamin Azizi, D.M.D.
Dentist, Orthodontics and Dentofacial Orthopedics in Glenside, PA. Individual provider (NPI-1).
NPI number1881744563
StatusActive
Last updated in NPPESDec 17, 2019
Details
- NPI
- 1881744563
- Entity type
- Individual (NPI-1)
- Name
- Dr. Khosrow Benjamin Azizi
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 12, 2007
- Certification date
- Dec 17, 2019
- Last updated
- Dec 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | DS025908L | PA | Yes |
Other names
- Benjamin K Azizi (Professional Name)
Practice location
242 N Keswick AveGlenside, PA 19038-4804
Phone 215-576-6414 · Fax 215-576-8497
Mailing address
242 N Keswick AveGlenside, PA 19038-4804
Phone 215-576-6414 · Fax 215-576-8497
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All 5 Orthodontics and Dentofacial Orthopedics Dentistry providers in Glenside · All 370 providers in Glenside
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