Provider Demographics
NPI:1235688821
Name:EMAN MIKHAIL D.D.S. DENTAL CORP
Entity Type:Organization
Organization Name:EMAN MIKHAIL D.D.S. DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-841-3939
Mailing Address - Street 1:6852 CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-4902
Mailing Address - Country:US
Mailing Address - Phone:323-841-3939
Mailing Address - Fax:
Practice Address - Street 1:5675 E LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2107
Practice Address - Country:US
Practice Address - Phone:714-695-0593
Practice Address - Fax:714-695-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-24
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty