Organization
AWNIE A AMMAR, DDS, PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AWNIE A AMMAR DDS (PRESIDENT)
(209) 239-7779
Entity
Organization
Contact information
Practice address
1104 N MAIN ST, MANTECA, CA 95336-3208
(209) 239-7779
Mailing address
1104 N MAIN ST, MANTECA, CA 95336-3208
(209) 239-7779
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
42094
CA
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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