| Dental Office | |
|
9635 Milliken Ave Ste # 103 Rancho Cucamonga CA 91730-9004 | |
| (909) 481-8990 | |
| Not Available |
| Full Name | Dental Office |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9635 Milliken Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Ziad Kassab (PRESIDENT) |
| Authorized Official Contact | 9094818990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Office 9635 Milliken Ave Ste # 103 Rancho Cucamonga CA 91730-9004 Ph: (909) 481-8990 | Dental Office 9635 Milliken Ave Ste # 103 Rancho Cucamonga CA 91730-9004 Ph: (909) 481-8990 |
| NPI Number | 1285968164 |
|---|---|
| Provider Enumeration Date | 09/25/2009 |
| Last Update Date | 09/25/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285968164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 49556 (California) | Primary |
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