Provider Demographics
NPI:1033506282
Name:AWAD AND MOORE DENTAL CORPORATION
Entity Type:Organization
Organization Name:AWAD AND MOORE DENTAL CORPORATION
Other - Org Name:POMONA DENTISTRY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-374-1815
Mailing Address - Street 1:17000 RED HILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614
Mailing Address - Country:US
Mailing Address - Phone:714-845-8890
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:2071 RANCHO VALLEY DR STE 140
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-7105
Practice Address - Country:US
Practice Address - Phone:909-374-1815
Practice Address - Fax:909-374-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty