# GARDEN GROVE MEDICAL AND DENTAL SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1518687888
- **Authorized official:** DR. MOHAMMAD ABDUL-FIELAT DDS (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (951) 818-6017

## Contact information

- **Practice address:** 12828 HARBOR BLVD STE 210, GARDEN GROVE, CA 92840-5834
- **Practice address phone:** (714) 844-9212
- **Practice address fax:** (714) 844-9212
- **Mailing address:** 12828 HARBOR BLVD STE 210, GARDEN GROVE, CA 92840-5834
- **Mailing address phone:** (714) 844-9212
- **Mailing address fax:** (714) 844-9212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/29/2022
- **Last updated:** 08/29/2022