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NPI Code Detail

MEDICARE: JAMAL DENTAL CORPORATION

MEDICARE: JAMAL DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist43350CA

General Provider Information

NPI Number : 1457602146
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMAL DENTAL CORPORATION
Provider Business Mailing Address
First Line : 255 N GILBERT ST STE C1
Second Line :
City : HEMET
State : CA
Zip : 92543-4078
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 255 N GILBERT ST STE C1
Second Line :
City : HEMET
State : CA
Zip : 92543-4078
Country : US
Telephone Number : 951-766-7990
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MANAR JAMAL
Credential :
Telephone Number : 951-766-7990
Provider Enumeration Date : 09/21/2012
Last Update Date : 12/01/2014

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Directions to “JAMAL DENTAL CORPORATION ” Practice Location

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