Provider Demographics
NPI:1891288890
Name:EHAB SAMAAN DDS INC
Entity Type:Organization
Organization Name:EHAB SAMAAN DDS INC
Other - Org Name:ALL CARE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMAAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-371-0113
Mailing Address - Street 1:19019 HAWTHORNE BLVD STE 100B
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1533
Mailing Address - Country:US
Mailing Address - Phone:310-371-0113
Mailing Address - Fax:310-371-1927
Practice Address - Street 1:19019 HAWTHORNE BLVD STE 100B
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-371-0113
Practice Address - Fax:310-371-1927
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EHAB SAMAAN DDS,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-13
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
CA497981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty