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General NPI Number Information
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NPI Number | 1588398069
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Entity Type | Individual
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Provider Name | DR. MINA SAMEH DAKRAN ROSE SALIB
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Gender | Male
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 250 E HANFORD ARMONA RD
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City | LEMOORE
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State | CA
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Zip | 93245-2132
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Country | US
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Telephone | 559-646-6618
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Fax |
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Provider Business Mailing Address
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Address Line | 3875 W BEECHWOOD AVE
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City | FRESNO
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State | CA
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Zip | 93711-0795
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Country | US
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Telephone | 559-646-6618
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Fax | 559-646-3652
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 108751
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License Number State | CA
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