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Individual
MR. MAMOUN K KHALIL
Active
Individual
MR. MAMOUN K KHALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
43801
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B4380101
MEDI CAL CA STATE PROGRAM
CA
Enumeration date
08/04/2006
Last updated
07/08/2007
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