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General NPI Number Information
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NPI Number | 1881826931
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Entity Type | Individual
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Provider Name | NOURA FADEL D.D.S. FAGD
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Gender | Female
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 720 BROOKSIDE AVE STE 100
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City | REDLANDS
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State | CA
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Zip | 92373-5189
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Country | US
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Telephone | 585-770-0592
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Fax |
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Provider Business Mailing Address
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Address Line | 720 BROOKSIDE AVE STE 100
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City | REDLANDS
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State | CA
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Zip | 92373-5189
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Country | US
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Telephone | 909-488-0222
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Fax |
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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 | 103342
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 125K00000X
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Taxonomy Name | Advanced Practice Dental Therapist
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License Number | 103342
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License Number State | CA
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