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General NPI Number Information
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NPI Number | 1396051157
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Entity Type | Organization
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Legal Business Name | SHAKIR & ALHASSAN DENTAL CORPORATION
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 9353 FAIRWAY VIEW PL SUITE 200
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0961
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Country | US
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Telephone | 909-987-9933
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Fax | 909-581-6669
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Provider Business Mailing Address
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Address Line | 9353 FAIRWAY VIEW PL SUITE 200
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0961
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Country | US
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Telephone | 909-987-9933
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Fax | 909-581-6669
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HALA S SHAKIR
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Credential | D.D.S.
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Telephone | 702-340-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 55755
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License Number State | CA
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