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4036 Grand Ave Ste D Chino CA 91710 | |
| (909) 627-9996 | |
| (909) 517-1035 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4036 Grand Ave, Chino, California |
| Authorized Official Name and Position | Daniel Dt Nguyen (OWNER PRESIDENT) |
| Authorized Official Contact | 9096279996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4036 Grand Ave Ste D Chino CA 91710 Ph: (909) 627-9996 | 4036 Grand Ave Ste D Chino CA 91710 Ph: (909) 627-9996 |
| NPI Number | 1760498091 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760498091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 47531 (California) | Primary |
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