Provider Demographics
NPI:1255103685
Name:SAWAF, MANAR (DDS)
Entity type:Individual
Prefix:
First Name:MANAR
Middle Name:
Last Name:SAWAF
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 1:1119 STONE PINE LN UNIT E
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-7537
Mailing Address - Country:US
Mailing Address - Phone:951-427-2257
Mailing Address - Fax:
Practice Address - Street 1:2808 W MONTE VISTA AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-8409
Practice Address - Country:US
Practice Address - Phone:209-667-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1096281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty