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Organization
KHASATI & AWWAD DENTAL CORP.
Active
Organization
KHASATI & AWWAD DENTAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHADI K. KHASATI D.D.S. (MANAGING DENTIST)
(951) 302-6222
Entity
Organization
Contact information
Practice address
33050 ANTELOPE RD, SUITE 207, MURRIETA, CA 92562
(951) 302-6222
(951) 302-2422
Mailing address
33050 ANTELOPE RD, SUITE 207, MURRIETA, CA 92562
(951) 302-6222
(951) 302-2422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
46741
CA
1223G0001X
General Practice Dentistry
Primary
504-78
CA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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