Provider Demographics
NPI:1760105282
Name:FAREID AND MOKBIL DENTAL CORPORATION
Entity Type:Organization
Organization Name:FAREID AND MOKBIL DENTAL CORPORATION
Other - Org Name:DENTISTS OF HANFORD DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOKBIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-312-2818
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:559-312-2818
Mailing Address - Fax:559-317-6905
Practice Address - Street 1:150 N 12TH AVE STE 109
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-6178
Practice Address - Country:US
Practice Address - Phone:559-312-2818
Practice Address - Fax:559-317-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty