| |
16128 Hawthorne Blvd Lawndale CA 90260-2931 | |
(310) 370-4511 | |
(310) 371-4549 |
Full Name | |
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Speciality | Dentist |
Location | 16128 Hawthorne Blvd, Lawndale, California |
Authorized Official Name and Position | Shorouq Sahawneh (OWNER/PRESIDENT) |
Authorized Official Contact | 7145786358 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Spectrum Center Dr Ste 100 Irvine CA 92618-4962 Ph: (714) 578-6358 | 16128 Hawthorne Blvd Lawndale CA 90260-2931 Ph: (310) 370-4511 |
NPI Number | 1376928572 |
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Provider Enumeration Date | 07/29/2015 |
Last Update Date | 07/29/2015 |
Identifier | Type | State | Issuer |
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1376928572 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 55643 (California) | Primary |
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