Organization
THAYER HUSSEIN DDS,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAYER HUSSEIN DDS (OWNER)
(714) 588-6500
Entity
Organization
Contact information
Practice address
13872 HARBOR BLVD STE 1A-3, GARDEN GROVE, CA 92843-4041
(714) 265-1000
(714) 265-1000
Mailing address
10591 RAMBLEWOOD DR, STANTON, CA 90680-2149
(714) 588-6500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
64043
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881030872
—
CA
Enumeration date
01/22/2018
Last updated
02/08/2018
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