Provider Demographics
NPI:1144206137
Name:KAMIL, MOHAMMAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:
Last Name:KAMIL
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 1:1500 E SPRUCE ST.
Mailing Address - Street 2:UNITE #D
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-8492
Mailing Address - Country:US
Mailing Address - Phone:714-225-2986
Mailing Address - Fax:
Practice Address - Street 1:USS NIMITZ ( CVN 68 )
Practice Address - Street 2:DENTAL DEPARTMENT
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96620 2820
Practice Address - Country:US
Practice Address - Phone:619-545-8711
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA533241223G0001X
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice