| JS Lid DDS, Inc. | |
|
9791 Baseline Rd. Rancho Cucamonga CA 91730 | |
| (909) 987-8779 | |
| (909) 987-2815 |
| Full Name | JS Lid DDS, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9791 Baseline Rd., Rancho Cucamonga, California |
| Authorized Official Name and Position | Johnny Lid (PRESIDENT) |
| Authorized Official Contact | 6763203611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| JS Lid DDS, Inc. 9791 Baseline Rd. Rancho Cucamonga CA 91730 Ph: (909) 987-8779 | JS Lid DDS, Inc. 9791 Baseline Rd. Rancho Cucamonga CA 91730 Ph: (909) 987-8779 |
| NPI Number | 1720471055 |
|---|---|
| Provider Enumeration Date | 03/11/2015 |
| Last Update Date | 03/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720471055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 51966 (California) | Primary |
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