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NPI Code Detail

MEDICARE: DUNYA G ANTWAN DDS INC,

MEDICARE: DUNYA G ANTWAN DDS INC,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist55683CA

General Provider Information

NPI Number : 1538405014
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUNYA G ANTWAN DDS INC,
Provider Business Mailing Address
First Line : 10450 FRIARS RD STE G
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-2311
Country : US
Telephone Number : 619-640-5100
Fax Number :
Provider Business Practice Location Address
First Line : 10450 FRIARS RD STE G
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-2311
Country : US
Telephone Number : 619-640-5100
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. DUNYA ANTWAN
Credential : DDS
Telephone Number : 619-788-6377
Provider Enumeration Date : 01/02/2013
Last Update Date : 01/02/2013

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Directions to “DUNYA G ANTWAN DDS INC, ” Practice Location

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