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General NPI Number Information
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NPI Number | 1194964866
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Entity Type | Organization
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Legal Business Name | ZIAD KASSAB D.D.S INC
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 1437 W ARROW HWY
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City | SAN DIMAS
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State | CA
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Zip | 91773-2331
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Country | US
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Telephone | 909-305-6900
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Fax | 909-305-6990
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Provider Business Mailing Address
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Address Line | 1437 W ARROW HWY
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City | SAN DIMAS
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State | CA
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Zip | 91773-2331
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Country | US
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Telephone | 909-305-6900
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Fax | 909-305-6990
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Authorized Official
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Title or Position | CEO
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Name | DR. ZIAD KASSAB
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Credential | D.D.S
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Telephone | 909-305-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 49556
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License Number State | CA
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