Organization
SHAABAN,D.D.S.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHADY SHAABAN (PRESIDENT)
(818) 288-6511
Entity
Organization
Contact information
Practice address
12752 GARDEN GROVE BLVD, SUITE 200, GARDEN GROVE, CA 92843-1923
(714) 636-2595
Mailing address
12752 GARDEN GROVE BLVD, SUITE 200, GARDEN GROVE, CA 92843-1923
(714) 636-2595
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
56794
CA
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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