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Individual

BASSAM TAHA AL-RAWI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, MS

Contact information

Practice address
2500 MAIN ST, RED BLUFF, CA 96080
(530) 934-4641
Mailing address
1112 BURTON DR APT C, REDDING, CA 96003-5010
(512) 766-6990

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
043858
PA
122300000X
Dentist
Primary
108150
CA

Other

Enumeration date
09/06/2017
Last updated
12/31/2023
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