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General NPI Number Information
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NPI Number | 1528545407
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Entity Type | Organization
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Legal Business Name | AMINA J CHAUDHRY DDS INC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 220 LAGUNA RD STE 1
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City | FULLERTON
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State | CA
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Zip | 92835-2523
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Country | US
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Telephone | 714-871-0300
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Fax | 714-871-3522
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Provider Business Mailing Address
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Address Line | 220 LAGUNA RD STE 1
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City | FULLERTON
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State | CA
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Zip | 92835-2523
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Country | US
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Telephone | 714-871-0300
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Fax | 714-871-3522
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Authorized Official
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Title or Position | DR.
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Name | DR. AMINA JAVAID SHELLY CHAUDHRY
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Credential | DDS
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Telephone | 714-871-0300
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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 | 101814
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License Number State | CA
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