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Organization

BARSOUM DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CASSANDRA L LANDIS (INSURANCE BILLER)
(909) 920-5222
Entity
Organization

Contact information

Practice address
258 E. 9TH STREET, UPLAND, CA 91786
(909) 920-5222
(909) 920-5220
Mailing address
258 E. 9TH STREET, UPLAND, CA 91786
(909) 920-5222
(909) 920-5220

Taxonomy

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

Other

Enumeration date
10/31/2018
Last updated
10/31/2018
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