Provider Demographics
NPI:1922542026
Name:MRIHIL, ADEL
Entity type:Individual
Prefix:
First Name:ADEL
Middle Name:
Last Name:MRIHIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 S SEPULVEDA BLVD APT 1-208
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6809
Mailing Address - Country:US
Mailing Address - Phone:805-280-9942
Mailing Address - Fax:
Practice Address - Street 1:2356 TAUMARSON RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1300
Practice Address - Country:US
Practice Address - Phone:509-303-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60677983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist