| Mataria Dental Group Pc | |
|
3610 Lomita Blvd Ste 202 Torrance CA 90505-3919 | |
| (310) 465-0565 | |
| Not Available |
| Full Name | Mataria Dental Group Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3610 Lomita Blvd Ste 202, Torrance, California |
| Authorized Official Name and Position | Ahmed Mataria (OWNER) |
| Authorized Official Contact | 3104650565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mataria Dental Group Pc 3610 Lomita Blvd Ste 202 Torrance CA 90505-3919 Ph: (310) 465-0565 | Mataria Dental Group Pc 3610 Lomita Blvd Ste 202 Torrance CA 90505-3919 Ph: (310) 465-0565 |
| NPI Number | 1376202176 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 12/09/2021 |
| Medicare PECOS PAC ID | 3870936636 |
|---|---|
| Medicare Enrollment ID | O20240208001705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376202176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Ahmed Rasmi Mataria |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1255567483 PECOS PAC ID: 1759685746 Enrollment ID: I20240208003251 |
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