Individual
AUSAMA GARGOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8653 FLORENCE AVE, DOWNEY, CA 90240
(562) 417-1688
Mailing address
3857 BIRCH ST SUITE 494, NEWPORT BEACH, CA 92660
(310) 871-1161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
106689
CA
Other
Enumeration date
12/04/2020
Last updated
05/13/2022
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