| Tony Daher Dds Inc | |
|
1413 Foothill Blvd #a Laverne CA 91750 | |
| (909) 596-6779 | |
| (909) 593-0969 |
| Full Name | Tony Daher Dds Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1413 Foothill Blvd, Laverne, California |
| Authorized Official Name and Position | Tony Daher (DENTIST OWNER) |
| Authorized Official Contact | 9095966779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tony Daher Dds Inc 1413 Foothill Blvd #a Laverne CA 91750 Ph: (909) 596-6779 | Tony Daher Dds Inc 1413 Foothill Blvd #a Laverne CA 91750 Ph: (909) 596-6779 |
| NPI Number | 1760583124 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 03/27/2024 |
| Medicare PECOS PAC ID | 5991146219 |
|---|---|
| Medicare Enrollment ID | O20240516002873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760583124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30334 (California) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Tony Daher |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225496771 PECOS PAC ID: 6800237124 Enrollment ID: I20240516002972 |
David A Tabata D D S Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1413 Foothill Blvd, Ste B, Laverne, CA 91750 Phone: 909-596-1833 Fax: 909-593-4722 |