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General NPI Number Information
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NPI Number | 1669798708
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Entity Type | Organization
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Legal Business Name | GHASSAN ARO DDS PROFFESSIONAL DENTAL CORP
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 1100 GROVE ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2914
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Country | US
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Telephone | 805-541-4290
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Fax | 805-541-4295
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Provider Business Mailing Address
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Address Line | 1100 GROVE ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2914
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Country | US
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Telephone | 805-541-4290
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Fax | 805-541-4295
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Authorized Official
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Title or Position | DENTIST /PRESIDENT
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Name | DR. GHASSAN ARO
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Credential | DDS
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Telephone | 805-541-4290
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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 | 49054
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License Number State | CA
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