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General NPI Number Information
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NPI Number | 1952817314
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Entity Type | Organization
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Legal Business Name | EMAD MOAWAD DENTAL CORPORATION
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 7631 WESTMINSTER BLVD. #A
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-622-5655
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Fax | 714-622-5686
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Provider Business Mailing Address
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Address Line | 7631 WESTMINSTER BLVD STE A
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City | WESTMINSTER
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State | CA
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Zip | 92683-3990
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Country | US
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Telephone | 714-622-5655
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EMAD MOAWAD
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Credential |
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Telephone | 714-622-5655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 48335
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License Number State | CA
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