Provider Demographics
NPI:1982813135
Name:KASSAB, ZIAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:
Last Name:KASSAB
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 1:1437 W ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-2331
Mailing Address - Country:US
Mailing Address - Phone:909-305-6900
Mailing Address - Fax:909-305-6990
Practice Address - Street 1:1437 W ARROW HWY
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2331
Practice Address - Country:US
Practice Address - Phone:909-305-6900
Practice Address - Fax:909-305-6990
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist