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General NPI Number Information
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NPI Number | 1659985802
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Entity Type | Organization
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Legal Business Name | RW FATTOUCH DMD, INC.
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 42210 LYNDIE LN STE 100
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City | TEMECULA
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State | CA
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Zip | 92591-3604
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Country | US
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Telephone | 951-506-1666
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Fax | 888-932-5863
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Provider Business Mailing Address
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Address Line | 42210 LYNDIE LN STE 100
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City | TEMECULA
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State | CA
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Zip | 92591-3604
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Country | US
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Telephone | 951-506-1666
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Fax | 888-932-5863
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT WADID FATTOUCH
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Credential | DMD
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Telephone | 951-506-1666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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