Provider Demographics
NPI:1083808125
Name:G E DEBBANEH DDS INC
Entity Type:Organization
Organization Name:G E DEBBANEH DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBBANEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-330-9200
Mailing Address - Street 1:927 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302
Mailing Address - Country:US
Mailing Address - Phone:310-330-9200
Mailing Address - Fax:310-330-9220
Practice Address - Street 1:927 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-2207
Practice Address - Country:US
Practice Address - Phone:310-330-9200
Practice Address - Fax:310-330-9220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty