Individual
DR. THAER BASIM ALQADOUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
81735 US HIGHWAY 111, SUITE A, INDIO, CA 92201-0713
(760) 238-4533
Mailing address
81735 US HIGHWAY 111, SUITE A, INDIO, CA 92201-0713
(760) 238-4533
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
100200
CA
1223P0300X
Periodontics
Primary
100200
CA
Other
Enumeration date
05/06/2016
Last updated
10/16/2022
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