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General NPI Number Information
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NPI Number | 1881095115
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Entity Type | Organization
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Legal Business Name | GEORGEI DENTAL GROUP
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Dates
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Enumeration Date | 09/05/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 23771 WASHINGTON AVE STE H102
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City | MURRIETA
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State | CA
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Zip | 92562-2265
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Country | US
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Telephone | 951-691-5096
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Fax | 951-691-5097
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Provider Business Mailing Address
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Address Line | 23771 WASHINGTON AVE STE H102
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City | MURRIETA
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State | CA
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Zip | 92562-2265
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Country | US
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Telephone | 951-691-5096
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Fax | 951-691-5097
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Authorized Official
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Title or Position | OWNER/DDS
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Name | RANIA GEORGEI
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Credential |
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Telephone | 951-691-5096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 53453
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License Number State | CA
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