Provider Demographics
NPI:1942594452
Name:ROUHANA, WILLIAM J (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:ROUHANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 E GARVEY AVE S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-2156
Mailing Address - Country:US
Mailing Address - Phone:626-859-2777
Mailing Address - Fax:626-859-2787
Practice Address - Street 1:2640 E GARVEY AVE S
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-2156
Practice Address - Country:US
Practice Address - Phone:626-859-2777
Practice Address - Fax:626-859-2787
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist