Provider Demographics
NPI:1235489303
Name:SEMRIEN DDS INC.
Entity Type:Organization
Organization Name:SEMRIEN DDS INC.
Other - Org Name:WILDOMAR DENTAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:MUSTAFA
Authorized Official - Last Name:SEMRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-678-4300
Mailing Address - Street 1:32100 CLINTON KEITH RD.
Mailing Address - Street 2:E
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7567
Mailing Address - Country:US
Mailing Address - Phone:951-678-4300
Mailing Address - Fax:951-678-4332
Practice Address - Street 1:32100 CLINTON KEITH RD
Practice Address - Street 2:E
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7566
Practice Address - Country:US
Practice Address - Phone:951-678-4300
Practice Address - Fax:951-678-4332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty