Individual
BASHAR DALLOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8997 MIRA MESA BLVD, SAN DIEGO, CA 92126-2738
(858) 536-5550
Mailing address
6465 BALBOA AVE, SUITE B, SAN DIEGO, CA 92111-3155
(858) 349-9201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
53445
CA
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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