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General NPI Number Information
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NPI Number | 1679062541
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Entity Type | Organization
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Legal Business Name | TOKATLI DENTAL GROUP INC
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 1875 W LA HABRA BLVD
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City | LA HABRA
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State | CA
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Zip | 90631
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Country | US
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Telephone | 562-266-0033
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Fax | 562-266-1927
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Provider Business Mailing Address
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Address Line | 1875 W LA HABRA BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-5131
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Country | US
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Telephone | 562-266-0033
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Fax | 562-266-1927
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AHMAD HASSAN TOKATLI
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Credential | DDS
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Telephone | 714-906-9940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 61437
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License Number State | CA
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