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290 E Douglas Ave El Cajon CA 92020-4514 | |
| (619) 442-0871 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 290 E Douglas Ave, El Cajon, California |
| Authorized Official Name and Position | Hazzaa Yahya (PARTNER/ DENTIST) |
| Authorized Official Contact | 6194420871 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
290 E Douglas Ave El Cajon CA 92020-4514 Ph: (619) 442-0871 | 290 E Douglas Ave El Cajon CA 92020-4514 Ph: (619) 442-0871 |
| NPI Number | 1366158826 |
|---|---|
| Provider Enumeration Date | 01/27/2023 |
| Last Update Date | 02/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366158826 | NPI | - | NPPES |
| 103970 | Other | CA | DENTAL LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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