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General NPI Number Information
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NPI Number | 1316568322
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Entity Type | Organization
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Legal Business Name | YAHYA DENTAL CORP
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 3509 SWEETWATER SPRINGS BLVD STE 1
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1064
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Country | US
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Telephone | 619-670-4471
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Fax | 619-670-8716
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Provider Business Mailing Address
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Address Line | 3509 SWEETWATER SPRINGS BLVD STE 1
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1064
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Country | US
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Telephone | 619-670-4471
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Fax | 619-670-8716
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAZZAA YAHYA
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Credential | D.M.D.
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Telephone | 619-670-4471
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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 |
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License Number State |
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