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General NPI Number Information
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NPI Number | 1225364680
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Entity Type | Individual
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Provider Name | OBADIAH MICHAEL ALLMARAS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 3551 PECK RD SUITE 101
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City | EL MONTE
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State | CA
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Zip | 91731-3547
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Country | US
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Telephone | 918-628-2528
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N COLLEGE PARK DR APT N36
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City | UPLAND
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State | CA
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Zip | 91786-8883
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Country | US
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Telephone | 918-628-2528
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Fax |
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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 | 6435-15
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 64101
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License Number State | CA
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