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Organization

ALAMITOS ORAL SURGERY

Active
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Organization

ALAMITOS ORAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SOLOMON POYOUROW D.D.S., M.D., M.P.H. (ORAL SURGEON/CO-OWNER)
(310) 279-0993
Entity
Organization

Contact information

Practice address
4582 KATELLA AVENUE, LOS ALAMITOS, CA 90720
(310) 279-0993
Mailing address
4582 KATELLA AVENUE, LOS ALAMITOS, CA 90720

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
55453
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
56129
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
58092
CA

Other

Enumeration date
02/11/2014
Last updated
02/18/2014
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