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Organization

MOLLER&IRENEDMD, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOLLER AWAD (CHIEF EXECUTIVE OFFICER)
(949) 689-3204
Entity
Organization

Contact information

Practice address
9092 TALBERT AVE STE 12, FOUNTAIN VALLEY, CA 92708-4475
(714) 963-6696
Mailing address
1747 GRAND AVE UNIT 4, LONG BEACH, CA 90804-2065

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
04/12/2022
Last updated
04/12/2022
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