| NPI | 1770022428 |
|---|---|
| Doing Business As | AMERICAN DENTAL GROUP OF WEST COVINA |
| Entity Type | Organization |
| Authorized Contact | HOMAN HANASAB President 626-337-7271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |