Healthcare Provider Details

I. General information

NPI: 1891273736
Provider Name (Legal Business Name): REEMA ARNOUK, D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S GRAND AVE STE 308
GLENDORA CA
91741-4283
US

IV. Provider business mailing address

210 S GRAND AVE STE 308
GLENDORA CA
91741-4283
US

V. Phone/Fax

Practice location:
  • Phone: 626-963-3322
  • Fax:
Mailing address:
  • Phone: 626-963-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REEMA ARNOUK
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 626-963-3322