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NPI 1780804328

NPI 1780804328 : MAHER NAKOUD D.D.S. : GRANADA HILLS, CA

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General NPI Number Information
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    NPI Number           |    1780804328
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    Entity Type          |    Individual 
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    Provider Name        |    MAHER NAKOUD D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/26/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    11856 1-8 BALBOA BLVD 
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    City                 |    GRANADA HILLS
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    State                |    CA
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    Zip                  |    91344
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    Country              |    US
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    Telephone            |    818-366-0001
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    Fax                  |    818-366-1755
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Provider Business Mailing Address
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    Address Line         |    11856 1/8 BALBOA BLVD. 
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    City                 |    GRANADA HILLS
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    State                |    CA
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    Zip                  |    91344
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    Country              |    US
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    Telephone            |    818-366-0001
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    Fax                  |    818-366-1755
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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       |    47529
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    License Number State |    CA
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