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607 W Channel Islands Blvd Port Hueneme CA 93041-2136 | |
(805) 985-2273 | |
(805) 985-2291 |
Full Name | |
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Speciality | Dentist |
Location | 607 W Channel Islands Blvd, Port Hueneme, California |
Authorized Official Name and Position | Tariq Hafez Alsamaan (DENTIST OWNER) |
Authorized Official Contact | 8059852273 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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607 W Channel Islands Blvd Port Hueneme CA 93041-2136 Ph: (805) 985-2273 | 607 W Channel Islands Blvd Port Hueneme CA 93041-2136 Ph: (805) 985-2273 |
NPI Number | 1588069116 |
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Provider Enumeration Date | 10/24/2014 |
Last Update Date | 02/05/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588069116 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 50884 (California) | Primary |
Dennis L Tank Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 W Channel Islands Blvd, 203, Port Hueneme, CA 93041 Phone: 805-985-0300 | |