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General NPI Number Information
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NPI Number | 1295244028
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Entity Type | Organization
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Legal Business Name | M K AWWAD DDS INC
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 33050 ANTELOPE RD STE 207
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City | MURRIETA
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State | CA
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Zip | 92563-2491
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Country | US
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Telephone | 951-672-6700
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Fax | 951-672-6200
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Provider Business Mailing Address
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Address Line | 33050 ANTELOPE RD STE 207
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City | MURRIETA
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State | CA
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Zip | 92563-2491
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Country | US
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Telephone | 951-672-6700
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Fax | 951-672-6200
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Authorized Official
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Title or Position | C.E.O. / DENTIST
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Name | MAHER K AWWAD
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Credential | DDS
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Telephone | 951-315-7033
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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 | 46741
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License Number State | CA
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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 | 46741
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License Number State | CA
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