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General NPI Number Information
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NPI Number | 1942807979
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Entity Type | Organization
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Legal Business Name | AYED HAWATMEH DDS INC
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 322 E FOOTHILL BLVD
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City | POMONA
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State | CA
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Zip | 91767
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Country | US
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Telephone | 909-769-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 E CONCOURS ST #A
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City | ONTARIO
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State | CA
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Zip | 91764
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Country | US
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Telephone | 909-483-1379
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Fax | 909-483-1729
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Authorized Official
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Title or Position | OWNER
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Name | AYED J HAWATMEH
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Credential |
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Telephone | 714-987-6916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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