| In Motion Dentists | |
|
2060 E Route 66 Ste 105 Glendora CA 91740-4691 | |
| (626) 594-0374 | |
| (626) 594-0813 |
| Full Name | In Motion Dentists |
|---|---|
| Speciality | Dentist |
| Location | 2060 E Route 66 Ste 105, Glendora, California |
| Authorized Official Name and Position | Wade Melvin Banner (OWNER) |
| Authorized Official Contact | 6265940374 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| In Motion Dentists 929 W. Foothill Blvd. Suite A La Verne CA 91750-3223 Ph: (626) 594-0374 | In Motion Dentists 2060 E Route 66 Ste 105 Glendora CA 91740-4691 Ph: (626) 594-0374 |
| NPI Number | 1417357518 |
|---|---|
| Provider Enumeration Date | 08/26/2014 |
| Last Update Date | 05/28/2024 |
| Certification Date | 05/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417357518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Secondary |
| 122300000X | Dentist | 63601 (California) | Primary |
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