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General NPI Number Information
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NPI Number | 1457602146
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Entity Type | Organization
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Legal Business Name | JAMAL DENTAL CORPORATION
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 255 N GILBERT ST STE C1
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City | HEMET
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State | CA
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Zip | 92543-4078
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Country | US
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Telephone | 951-766-7990
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Fax |
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Provider Business Mailing Address
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Address Line | 255 N GILBERT ST STE C1
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City | HEMET
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State | CA
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Zip | 92543-4078
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANAR JAMAL
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Credential |
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Telephone | 951-766-7990
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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 | 43350
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License Number State | CA
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