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General NPI Number Information
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NPI Number | 1538483623
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Entity Type | Organization
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Legal Business Name | M.J. AMINI DENTAL CORP.
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 2001 WEST 17TH STREET
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City | SANTA ANA
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State | CA
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Zip | 92706
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Country | US
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Telephone | 714-547-4444
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Fax | 714-547-4433
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Provider Business Mailing Address
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Address Line | PO BOX #6398
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City | SANTA ANA
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State | CA
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Zip | 92706
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Country | US
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Telephone | 714-547-4444
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Fax | 714-547-4433
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | MR. MOHAMMAD JOHN AMINI DETNAL CORPORATION
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Credential | DDS
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Telephone | 714-547-4444
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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 | 47032
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License Number State | CA
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