Provider Demographics
NPI:1417234162
Name:MANAL AZIZ DDS INC
Entity Type:Organization
Organization Name:MANAL AZIZ DDS INC
Other - Org Name:FAMILY DENTAL CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANAL
Authorized Official - Middle Name:MICHEL
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-307-2152
Mailing Address - Street 1:14150 CULVER DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0315
Mailing Address - Country:US
Mailing Address - Phone:949-559-6565
Mailing Address - Fax:949-559-6057
Practice Address - Street 1:14150 CULVER DR
Practice Address - Street 2:SUITE 205
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-0315
Practice Address - Country:US
Practice Address - Phone:949-559-6565
Practice Address - Fax:949-559-6057
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANAL AZIZ,DDS,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-09
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty