Provider Demographics
NPI:1891546420
Name:YOUSEPH ANWAR DDS INC
Entity Type:Organization
Organization Name:YOUSEPH ANWAR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-364-2535
Mailing Address - Street 1:844 CHRISTY CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-8719
Mailing Address - Country:US
Mailing Address - Phone:510-364-2535
Mailing Address - Fax:
Practice Address - Street 1:3110 BUCHANAN RD STE B
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4427
Practice Address - Country:US
Practice Address - Phone:510-364-2535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental