| Maxwell M Nazari Dds Inc | |
|
355 S Lemon Ave Walnut CA 91789-2737 | |
| (909) 528-3594 | |
| Not Available |
| Full Name | Maxwell M Nazari Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 355 S Lemon Ave, Walnut, California |
| Authorized Official Name and Position | Maxwell Nazari (OWNER) |
| Authorized Official Contact | 9095283594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxwell M Nazari Dds Inc 355 S Lemon Ave Walnut CA 91789-2737 Ph: (909) 528-3594 | Maxwell M Nazari Dds Inc 355 S Lemon Ave Walnut CA 91789-2737 Ph: (909) 528-3594 |
| NPI Number | 1023646791 |
|---|---|
| Provider Enumeration Date | 03/30/2020 |
| Last Update Date | 03/30/2020 |
| Medicare PECOS PAC ID | 5395175467 |
|---|---|
| Medicare Enrollment ID | O20200414002123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023646791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Maxwell M Nazari |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1134263320 PECOS PAC ID: 1557682689 Enrollment ID: I20200414002235 |
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