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Organization
SURYAH HABIBI, DMD, INC
Active
Organization
SURYAH HABIBI, DMD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURYAH HABIBI DMD, MPH (OWNER DENTIST)
(949) 282-7428
Entity
Organization
Contact information
Practice address
17542 IRVINE BLVD STE D, TUSTIN, CA 92780-3155
(949) 282-7428
Mailing address
17542 IRVINE BLVD STE D, TUSTIN, CA 92780-3155
(949) 282-7428
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100863
DENTIST
CA
Enumeration date
12/27/2021
Last updated
12/27/2021
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