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407 W Madison Ave El Cajon CA 92020-3226 | |
| (619) 401-0444 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 407 W Madison Ave, El Cajon, California |
| Authorized Official Name and Position | Wisam Al-rawi (DENTIST) |
| Authorized Official Contact | 4246668116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
407 W Madison Ave El Cajon CA 92020-3226 Ph: (619) 401-0444 | 407 W Madison Ave El Cajon CA 92020-3226 Ph: (619) 401-0444 |
| NPI Number | 1164065421 |
|---|---|
| Provider Enumeration Date | 10/19/2019 |
| Last Update Date | 02/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164065421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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