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General NPI Number Information
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NPI Number | 1053847947
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Entity Type | Organization
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Legal Business Name | O. EL HILLAL DMD, MS DENTAL CORP
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 33 CREEK RD SUITE 280
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City | IRVINE
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State | CA
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Zip | 92604-4791
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Country | US
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Telephone | 949-551-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 8272 W LAKE PLEASANT PKWY STE 209
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City | PEORIA
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State | AZ
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Zip | 85382-7432
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Country | US
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Telephone | 623-376-6464
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. OUSAMA EL-HILLAL
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Credential | DMD, MS
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Telephone | 623-376-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DDS100864
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License Number State | CA
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