Raed S Fawaz, BS DDS Valid NPI
Individual provider · General Practice Dentistry · Mission Viejo, CA
- NPI
- 1740473412
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 42149 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2007-08-24
- Last updated
- 2007-08-24
Practice location
26902 Oso Pkwy, 190
Mission Viejo, CA 92691-5801
(949) 582-9206