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8402 Commonwealth Ave Buena Park CA 90621-2528 | |
| (714) 739-2051 | |
| (714) 739-5146 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8402 Commonwealth Ave, Buena Park, California |
| Authorized Official Name and Position | Mona Adel Fahmy (OWNER/DENTIST) |
| Authorized Official Contact | 7147392051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8402 Commonwealth Ave Buena Park CA 90621-2528 Ph: (714) 739-2051 | 8402 Commonwealth Ave Buena Park CA 90621-2528 Ph: (714) 739-2051 |
| NPI Number | 1467857391 |
|---|---|
| Provider Enumeration Date | 11/04/2014 |
| Last Update Date | 11/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467857391 | NPI | - | NPPES |
| B39358-01 | Other | CA | DENTI-CAL (MEDI-CAL) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39358 (California) | Primary |
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