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General NPI Number Information
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NPI Number | 1023411204
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Entity Type | Organization
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Legal Business Name | BEGUWALA DENTAL CORPORATION
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 854 MAGNOLIA AVE SUITE D
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City | CORONA
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State | CA
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Zip | 92879-3109
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Country | US
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Telephone | 951-736-8884
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Fax |
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Provider Business Mailing Address
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Address Line | 854 MAGNOLIA AVE SUITE D
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City | CORONA
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State | CA
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Zip | 92879-3109
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Country | US
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Telephone | 951-736-8884
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SUHAIL BEGUWALA
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Credential |
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Telephone | 949-285-9495
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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 | 53578
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License Number State | CA
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