Organization
HOMAN HANASAB DENTAL CORPORATION
Active
Other names
American Dental Group of West Covina
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMAN HANASAB DDS, MS (PRESIDENT)
(626) 337-7271
Entity
Organization
Contact information
Practice address
436 N SUNSET AVE, WEST COVINA, CA 91790-1652
(626) 337-7271
(626) 337-8125
Mailing address
436 N SUNSET AVE, WEST COVINA, CA 91790-1652
(626) 337-7271
(626) 337-8125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
CA
1223E0200X
Endodontics
—
CA
1223P0300X
Periodontics
Primary
—
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
CA
124Q00000X
Dental Hygienist
—
CA
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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