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Organization
MUSSIE SIBHATU DDS, A DENTAL CORPORATION
Active
Organization
MUSSIE SIBHATU DDS, A DENTAL CORPORATION
Active
Parent organization
MUSSIE SIBHATU DDS
Other names
Laurel Smile Dentistry, Oakland Smile Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
MUSSIE SIBHATU DDS
Authorized official
DR. MUSSIE SIBHATU DDS, MS (DENTIST OWNER)
(510) 520-1533
Entity
Organization
Contact information
Practice address
3630 MACARTHUR BLVD, OAKLAND, CA 94619-1328
(510) 530-3317
(510) 530-3370
Mailing address
3147 TELEGRAPH AVE, OAKLAND, CA 94609-3206
(510) 420-1717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1288907
DENTAL INSURANCE
CA
Enumeration date
02/09/2022
Last updated
02/09/2022
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