Farwest Dental Group

NPI #1699200220 in Wilmington, California

Provider Information

NPI Number: 1699200220
Entity Type: Organization
Organization Name: Farwest Dental Group
Primary Specialty: Dentist
Enumeration Date: Apr 20, 2017
Last Updated: Apr 20, 2017

Practice Location

Address: 1704 N AVALON BLVD
City: Wilmington
State: California
ZIP Code: 90744-1433
Phone: (310) 835-5130

Authorized Official

Name: DR. HASSAN FAYOUMI, DDS
Title: ONWER
Phone: (310) 699-1549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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