| American Dental Center | |
|
3318 E Anaheim St Long Beach CA 90804-4025 | |
| (562) 986-5570 | |
| (562) 986-9791 |
| Full Name | American Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 3318 E Anaheim St, Long Beach, California |
| Authorized Official Name and Position | Bashar Komoc (PRESIDENT) |
| Authorized Official Contact | 5629865570 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Dental Center 3318 E Anaheim St Long Beach CA 90804-4025 Ph: (562) 986-5570 | American Dental Center 3318 E Anaheim St Long Beach CA 90804-4025 Ph: (562) 986-5570 |
| NPI Number | 1114181260 |
|---|---|
| Provider Enumeration Date | 07/17/2008 |
| Last Update Date | 07/17/2008 |
| Medicare PECOS PAC ID | 6800126640 |
|---|---|
| Medicare Enrollment ID | O20190923000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114181260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42317 (California) | Primary |
| Provider Name | Bashar Komoc |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1437290897 PECOS PAC ID: 0446552301 Enrollment ID: I20190923001169 |
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