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Organization

BARSOUM DENTAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAHER LABIB BARSOUM DDS (CHIEF EXECUTIVE OFFICER)
(909) 902-1708
Entity
Organization

Contact information

Practice address
14613 RAMONA AVE, CHINO, CA 91710
(909) 902-1708
(909) 902-1709
Mailing address
14613 RAMONA AVE, CHINO, CA 91710
(909) 902-1708
(909) 902-1709

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
57231
CA
1223G0001X
General Practice Dentistry
Primary
44145
CA
1223P0300X
Periodontics
64229
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
64108
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
61000
CA

Other

Enumeration date
01/03/2018
Last updated
01/03/2018
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