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Organization

COSMETIC DENTISTRY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HASSAN HAMAMI ALHAOUASLI DDS (OWNER)
(714) 965-1093
Entity
Organization

Contact information

Practice address
10810 WARNER AVE STE 1, FOUNTAIN VALLEY, CA 92708-3848
(714) 965-1093
(714) 965-1083
Mailing address
10810 WARNER AVE STE 1, FOUNTAIN VALLEY, CA 92708-3848
(714) 965-1093
(714) 965-1083

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48215
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G92795-01
CA
Enumeration date
10/25/2011
Last updated
10/25/2011
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