Provider Demographics
NPI:1093722704
Name:ASCHA, MOHAMMAD YASSER (DDS)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:YASSER
Last Name:ASCHA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W COVINA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773
Mailing Address - Country:US
Mailing Address - Phone:909-599-3685
Mailing Address - Fax:909-592-5927
Practice Address - Street 1:1111 W COVINA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773
Practice Address - Country:US
Practice Address - Phone:909-599-3685
Practice Address - Fax:909-592-5927
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice