Farwest Dental Group, PC
NPI #1023598836 in Wilmington, California
Provider Information
- NPI Number
- 1023598836
- Entity Type
- Organization
- Organization Name
- Farwest Dental Group, PC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Aug 21, 2018
- Last Updated
- Aug 21, 2018
Practice Location
- Address
- 1704 N AVALON BLVD
- City
- Wilmington
- State
- California
- ZIP Code
- 90744-1433
- Phone
- (310) 835-5030
Authorized Official
- Name
- HASSAN FAYOUMI, DDS
- Title
- CEO
- Phone
- (310) 699-1549
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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