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General NPI Number Information
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NPI Number | 1083975767
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Entity Type | Individual
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Provider Name | SAIF WALID LISWI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 101 W MISSION BLVD SUITE 221
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City | POMONA
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State | CA
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Zip | 91766-1711
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Country | US
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Telephone | 909-622-6633
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Fax | 909-622-6630
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Provider Business Mailing Address
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Address Line | 101 W MISSION BLVD SUITE 221
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City | POMONA
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State | CA
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Zip | 91766-1711
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Country | US
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Telephone | 909-622-6633
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Fax | 909-622-6630
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 61355
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License Number State | CA
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