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Organization

GUERGUIS PROFESSIONAL DENTAL, INC.

Active
Other names
Bloomfield Dental Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IHAAB WADIE GUERGUIS DDS (PRESIDENT)
(562) 926-6502
Entity
Organization

Contact information

Practice address
12657 166TH ST, CERRITOS, CA 90703-2101
(562) 926-6502
Mailing address
12657 166TH ST, CERRITOS, CA 90703-2101
(562) 926-6502

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/29/2019
Last updated
03/29/2019
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