Provider Demographics
NPI:1205071651
Name:ANGELS FAMILY DENTAL
Entity type:Organization
Organization Name:ANGELS FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.D.S
Authorized Official - Prefix:
Authorized Official - First Name:ESKANDER
Authorized Official - Middle Name:YOUSSEF
Authorized Official - Last Name:ESKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-277-5800
Mailing Address - Street 1:3664 W SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3231
Mailing Address - Country:US
Mailing Address - Phone:559-277-5800
Mailing Address - Fax:
Practice Address - Street 1:3664 WEST SHAW AVENUE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711
Practice Address - Country:US
Practice Address - Phone:559-277-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty