Provider Demographics
NPI:1134754625
Name:MUSTAFA KHALID DDS INC.
Entity type:Organization
Organization Name:MUSTAFA KHALID DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-420-6030
Mailing Address - Street 1:309 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3910
Mailing Address - Country:US
Mailing Address - Phone:619-420-6030
Mailing Address - Fax:619-420-9102
Practice Address - Street 1:309 THIRD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3910
Practice Address - Country:US
Practice Address - Phone:619-420-6030
Practice Address - Fax:619-420-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty