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ETHAR RIYADH AL-WAZEER DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1366054348

Individual Registrant:
 ETHAR RIYADH AL-WAZEER DDS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
10144 SIERRA AVE  FONTANA, CA 92335-6725 US
Tel: 909-770-7367  Fax: --

Contact information for business:
1510 ORANGE AVE APT 304  REDLANDS, CA 92373-1493 US
Tel: 630-408-9723  Fax: --

Registration Information:
NPI: 1366054348
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA105309

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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