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General NPI Number Information
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NPI Number | 1831741669
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Entity Type | Organization
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Legal Business Name | MAHMOOD D.D.S., DENTAL CORP
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 6475 ALVARADO RD STE 205
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City | SAN DIEGO
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State | CA
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Zip | 92120-5013
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Country | US
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Telephone | 619-287-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 6475 ALVARADO RD STE 205
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City | SAN DIEGO
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State | CA
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Zip | 92120-5013
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Country | US
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Telephone | 619-287-0990
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. TRUSKA MAHMOOD
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Credential | DDS
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Telephone | 619-287-1990
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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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