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General NPI Number Information
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NPI Number | 1013032374
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Entity Type | Organization
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Legal Business Name | MONEIM DENTAL CORP.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 OAK MEADOW DR
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City | LOS GATOS
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State | CA
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Zip | 95032-4407
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Country | US
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Telephone | 408-354-7333
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Fax | 408-354-7433
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Provider Business Mailing Address
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Address Line | 220 OAK MEADOW DR
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City | LOS GATOS
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State | CA
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Zip | 95032-4407
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Country | US
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Telephone | 408-354-7333
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Fax | 408-354-7433
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Authorized Official
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Title or Position | CEO
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Name | DR. ADAM A MONEIM
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Credential | D.D.S
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Telephone | 408-354-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 45593
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License Number State | CA
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