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General NPI Number Information
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NPI Number | 1316349822
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Entity Type | Organization
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Legal Business Name | AMMARI DENTAL PC
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 1344 S CHAMBERS RD SUITE 203
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City | AURORA
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State | CO
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Zip | 80017-4096
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Country | US
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Telephone | 303-283-8009
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Fax | 303-337-7809
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Provider Business Mailing Address
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Address Line | 1344 S CHAMBERS RD SUITE 203
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City | AURORA
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State | CO
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Zip | 80017-4096
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Country | US
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Telephone | 303-283-8009
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Fax | 303-337-7809
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAED AMMARI
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Credential | DDS
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Telephone | 714-686-2541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 10099
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License Number State | CO
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