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General NPI Number Information
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NPI Number | 1811372089
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Entity Type | Organization
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Legal Business Name | POOJA ASWANI DENTAL CORPORATION
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 12923 INGLEWOOD AVE #3
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City | HAWTHORNE
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State | CA
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Zip | 90250-5139
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Country | US
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Telephone | 310-263-1030
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Fax | 310-263-1043
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Provider Business Mailing Address
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Address Line | 12923 INGLEWOOD AVE #3
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City | HAWTHORNE
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State | CA
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Zip | 90250-5139
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Country | US
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Telephone | 310-263-1030
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Fax | 310-263-1043
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. POOJA ASWANI
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Credential | DDS
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Telephone | 310-869-5527
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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 | 49282
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License Number State | CA
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