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General NPI Number Information
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NPI Number | 1467857391
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Entity Type | Organization
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Legal Business Name | MONA A FAHMY D.D.S. INC.
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 8402 COMMONWEALTH AVE
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City | BUENA PARK
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State | CA
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Zip | 90621-2528
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Country | US
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Telephone | 714-739-2051
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Fax | 714-739-5146
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Provider Business Mailing Address
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Address Line | 8402 COMMONWEALTH AVE
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City | BUENA PARK
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State | CA
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Zip | 90621-2528
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Country | US
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Telephone | 714-739-2051
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Fax | 714-739-5146
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. MONA ADEL FAHMY
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Credential | D.D.S.
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Telephone | 714-739-2051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39358
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License Number State | CA
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