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Organization
SOROUR DENTAL GROUP CORP
Active
Organization
SOROUR DENTAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SELVANA SOROUR D.M.D (VICE PRESIDENT)
(310) 795-3363
Entity
Organization
Contact information
Practice address
3173 TWEEDY BLVD, SOUTH GATE, CA 90280-5739
(323) 564-4554
Mailing address
13340 HAWTHORNE BLVD, HAWTHORNE, CA 90250-5805
(310) 795-3363
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
CA
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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