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General NPI Number Information
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NPI Number | 1376042853
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Entity Type | Organization
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Legal Business Name | ALLEN MOSSAEI DDS INC
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Dates
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Enumeration Date | 02/09/2018
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 4829 PANAMA LN UNIT C
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City | BAKERSFIELD
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State | CA
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Zip | 93313-3482
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Country | US
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Telephone | 661-999-1501
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Fax | 661-412-4495
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Provider Business Mailing Address
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Address Line | 4829 PANAMA LN UNIT C
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City | BAKERSFIELD
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State | CA
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Zip | 93313-3482
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Country | US
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Telephone | 661-999-1501
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Fax | 661-412-4495
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. ALLEN MOSSAEI
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Credential | DDS
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Telephone | 661-999-1501
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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 | 59083
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License Number State | CA
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