Provider Demographics
NPI:1588185516
Name:MOKBIL DENTAL CORPORATION
Entity type:Organization
Organization Name:MOKBIL DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOKBIL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-246-1108
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:714-845-8500
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:4022 SUNRISE BLVD,.
Practice Address - Street 2:STE 160
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742
Practice Address - Country:US
Practice Address - Phone:916-246-1108
Practice Address - Fax:916-668-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty