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MAISSA RSTOUM AGHA DDS
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1982792115
Individual Registrant: MAISSA RSTOUM AGHA DDS
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
3441 W BALL RD #A ANAHEIM, CA 92804 US
Tel: 714-827-3441 Fax: 714-827-0232
Tel: 714-827-3441 Fax: 714-827-0232
Contact information for business:
3441 W BALL RD #A ANAHEIM, CA 92804 US
Tel: 714-827-3441 Fax: 714-827-0232
Tel: 714-827-3441 Fax: 714-827-0232
Registration Information:
NPI: 1982792115
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | CA | 43106 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| DENTI CAL | B4310602 | CA | 01 |
