Organization
ATEF R REZKALLA DDS INC
Active
Other names
Long Beach Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ATEF R. REZKALLA DDS (OWNER)
(562) 436-4214
Entity
Organization
Contact information
Practice address
308 ORANGE AVE, LONG BEACH, CA 90802-3536
(562) 436-4214
Mailing address
308 ORANGE AVE, LONG BEACH, CA 90802-3536
(562) 436-4214
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G89823
—
CA
Enumeration date
05/09/2007
Last updated
02/06/2008
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