Organization
AL KHATEEB D.D.S DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HISHAM ALKHATHEEB D.D.S (OWNER)
(714) 000-0000
Entity
Organization
Contact information
Practice address
267 E 17TH ST, COSTA MESA, CA 92627-3831
(714) 000-0000
Mailing address
267 E 17TH ST, COSTA MESA, CA 92627-3831
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
41699
CA
Other
Enumeration date
10/17/2016
Last updated
04/19/2017
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