# ALAMITOS ORAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043634124
- **Authorized official:** SOLOMON POYOUROW D.D.S., M.D., M.P.H. (ORAL SURGEON/CO-OWNER)
- **Authorized official phone:** (310) 279-0993

## Contact information

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

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 55453 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 56129 | CA | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 58092 | CA | — |

## Other

- **Enumeration date:** 02/11/2014
- **Last updated:** 02/18/2014