Organization
ATEF BOUTROS DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ATEF A BOUTROS DDS (DENTIST)
(562) 912-4367
Entity
Organization
Contact information
Practice address
1183 E ANAHEIM STREET, LONG BEACH, CA 90813
(562) 912-4367
(562) 912-4369
Mailing address
1183 E ANAHEIM STREET, LONG BEACH, CA 90813
(562) 912-4367
(562) 912-4369
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G93926-01
—
CA
Enumeration date
01/10/2007
Last updated
10/24/2023
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