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NPI Code Detail

MEDICARE: WOOD AND HABASHY DENTAL PARTNERSHIP

MEDICARE: WOOD AND HABASHY DENTAL PARTNERSHIP
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
11223G0001XGeneral Practice Dentistry
21223P0300XPeriodontics
31223S0112XOral and Maxillofacial Surgery (Dentist)
41223E0200XEndodontics

General Provider Information

NPI Number : 1720779390
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOOD AND HABASHY DENTAL PARTNERSHIP
Provider Business Mailing Address
First Line : 6711 GREENLEAF AVE
Second Line :
City : WHITTIER
State : CA
Zip : 90601-4110
Country : US
Telephone Number : 562-698-0054
Fax Number :
Provider Business Practice Location Address
First Line : 6711 GREENLEAF AVE
Second Line :
City : WHITTIER
State : CA
Zip : 90601-4110
Country : US
Telephone Number : 562-698-0054
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : MARK WOOD
Credential : DDS
Telephone Number : 248-770-0411
Provider Enumeration Date : 05/16/2023
Last Update Date : 05/16/2023

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