Provider Demographics
NPI:1295244028
Name:M K AWWAD DDS INC
Entity type:Organization
Organization Name:M K AWWAD DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O. / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:AWWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-315-7033
Mailing Address - Street 1:33050 ANTELOPE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2491
Mailing Address - Country:US
Mailing Address - Phone:951-672-6700
Mailing Address - Fax:951-672-6200
Practice Address - Street 1:33050 ANTELOPE RD STE 207
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2491
Practice Address - Country:US
Practice Address - Phone:951-672-6700
Practice Address - Fax:951-672-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467411223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty