Organization
AQIB MUDASSAR D.D.S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AQIB MUDASSAR (DENTIST)
(559) 662-1010
Entity
Organization
Contact information
Practice address
475 E ALMOND AVE STE 103, MADERA, CA 93637-5750
(559) 662-1010
(559) 662-0942
Mailing address
475 E ALMOND AVE STE 103, MADERA, CA 93637-5750
(559) 662-1010
(559) 662-0942
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
50790
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G92948-01
MEDICAL
CA
Enumeration date
04/08/2009
Last updated
12/18/2012
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