Provider Demographics
NPI:1033345111
Name:DOUGLAS A. DAWS, D.D.S.,INC
Entity Type:Organization
Organization Name:DOUGLAS A. DAWS, D.D.S.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAWS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-242-8955
Mailing Address - Street 1:3390 LOMA VISTA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3078
Mailing Address - Country:US
Mailing Address - Phone:818-242-8955
Mailing Address - Fax:
Practice Address - Street 1:1023 N BRAND BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2906
Practice Address - Country:US
Practice Address - Phone:818-242-8955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOUGLAS A. DAWS, D.D.S., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-03
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty