Provider Information for 1578621355
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Dr. FIRAS JAMIL HUSEIN DDS
Sex: Male
NPI: 1578621355
Last Updated: 2008-02-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1578621355 | ||||||||
| Enumeration Date | 2006-12-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 701 SONOMA MOUNTAIN PKWY STE E1 PETALUMA, CA 94954-8519 United States Phone: 707-782-0789 | Fax:707-782-9133 | ||||||||
| Primary Practice Address | 701 SONOMA MOUNTAIN PKWY STE E1 PETALUMA, CA 94954-8519 United States Phone: 707-782-0789 | Fax:707-782-9133 | ||||||||
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