Healthcare Provider Details

I. General information

NPI: 1730337379
Provider Name (Legal Business Name): ROFAEL DENTAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17150 EUCLID ST STE 311
FOUNTAIN VALLEY CA
92708-4092
US

IV. Provider business mailing address

17150 EUCLID ST STE 311
FOUNTAIN VALLEY CA
92708-4092
US

V. Phone/Fax

Practice location:
  • Phone: 714-444-4224
  • Fax: 714-444-9480
Mailing address:
  • Phone: 714-444-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. MEDHAT M. RAOUF ROFAEL
Title or Position: DDS
Credential:
Phone: 714-444-4224