Provider Demographics
NPI:1134582752
Name:LAILA-CHRISTINE ASSAAD, DMD, A PROFESSIONAL CORP
Entity type:Organization
Organization Name:LAILA-CHRISTINE ASSAAD, DMD, A PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAILA-CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSAAD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:661-347-1793
Mailing Address - Street 1:23884 COPPERHILL DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1701
Mailing Address - Country:US
Mailing Address - Phone:661-347-1793
Mailing Address - Fax:
Practice Address - Street 1:23884 COPPERHILL DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354-1701
Practice Address - Country:US
Practice Address - Phone:661-347-1793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA646321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty