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General NPI Number Information
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NPI Number | 1871482877
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Entity Type | Organization
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Legal Business Name | AUSTIN NAHOURAY DENTAL CORPORATION
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 8200 LONG BEACH BLVD STE E
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City | SOUTH GATE
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State | CA
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Zip | 90280-2075
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Country | US
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Telephone | 323-581-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 2337 ROSCOMARE RD STE 2-326
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City | LOS ANGELES
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State | CA
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Zip | 90077-1854
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AUSTIN NAHOURAY
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Credential | DDS
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Telephone | 310-612-3559
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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 |
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License Number State |
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