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General NPI Number Information
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NPI Number | 1235378860
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Entity Type | Organization
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Legal Business Name | DABBAGH AND AL TEIR DENTAL CORPORATION
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 2424 W BALL RD SUITE L
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City | ANAHEIM
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State | CA
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Zip | 92804-5272
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Country | US
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Telephone | 714-826-9000
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Fax | 714-827-8000
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Provider Business Mailing Address
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Address Line | 2424 W BALL RD SUITE L
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City | ANAHEIM
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State | CA
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Zip | 92804-5272
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Country | US
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Telephone | 714-826-9000
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Fax | 714-827-8000
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Authorized Official
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Title or Position | CEO
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Name | NIZAR ALTEIR
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Credential | DDS
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Telephone | 714-826-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41339
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39783
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License Number State | CA
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