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General NPI Number Information
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NPI Number | 1982000923
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Entity Type | Organization
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Legal Business Name | HAWATMEH DENTAL, PC
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 391 W CENTRAL AVE
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City | BREA
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State | CA
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Zip | 92821-3025
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Country | US
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Telephone | 714-987-6916
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Fax | 714-987-6920
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Provider Business Mailing Address
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Address Line | 391 W CENTRAL AVE
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City | BREA
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State | CA
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Zip | 92821-3025
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Country | US
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Telephone | 714-987-6916
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Fax | 714-987-6920
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Authorized Official
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Title or Position | OWNER
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Name | AYED HAWATMEH
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Credential | DDS
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 49108
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License Number State | CA
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