| Cosmetic Laser Dentistry | |
|
639 E. Foothill Blvd Suite A San Dimas CA 91773 | |
| (909) 599-2029 | |
| (909) 599-4342 |
| Full Name | Cosmetic Laser Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 639 E. Foothill Blvd, San Dimas, California |
| Authorized Official Name and Position | Maher Al-bouz (OWNER) |
| Authorized Official Contact | 9095992029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cosmetic Laser Dentistry 639 E. Foothill Blvd Suite A San Dimas CA 91773 Ph: (909) 599-2029 | Cosmetic Laser Dentistry 639 E. Foothill Blvd Suite A San Dimas CA 91773 Ph: (909) 599-2029 |
| NPI Number | 1861701971 |
|---|---|
| Provider Enumeration Date | 10/07/2010 |
| Last Update Date | 10/07/2010 |
| Medicare PECOS PAC ID | 3577715077 |
|---|---|
| Medicare Enrollment ID | O20121207000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861701971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 46013 (California) | Primary |
| Provider Name | Maher Albouz |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033314232 PECOS PAC ID: 6103078605 Enrollment ID: I20121210000124 |
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