Healthcare Provider Details

I. General information

NPI: 1194028126
Provider Name (Legal Business Name): MUHAMMAD MUZAFFAR HUSSAIN QURESHI DDS.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MUZAFFAR HUSSAIN QURESHI DDS

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 N GRAND AVE
SANTA ANA CA
92705-8750
US

IV. Provider business mailing address

2710 N GRAND AVE
SANTA ANA CA
92705-8750
US

V. Phone/Fax

Practice location:
  • Phone: 714-244-9239
  • Fax:
Mailing address:
  • Phone: 714-244-9239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number41523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: