Provider Demographics
NPI:1316349822
Name:AMMARI DENTAL PC
Entity type:Organization
Organization Name:AMMARI DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAED
Authorized Official - Middle Name:
Authorized Official - Last Name:AMMARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-686-2541
Mailing Address - Street 1:1344 S CHAMBERS RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4096
Mailing Address - Country:US
Mailing Address - Phone:303-283-8009
Mailing Address - Fax:303-337-7809
Practice Address - Street 1:1344 S CHAMBERS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4096
Practice Address - Country:US
Practice Address - Phone:303-283-8009
Practice Address - Fax:303-337-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10099261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental