| None | |
|
190 W H St Suite 100 Colton CA 92324 | |
| (909) 825-1155 | |
| (909) 825-0275 |
| Full Name | None |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 190 W H St Suite 100, Colton, California |
| Authorized Official Name and Position | Jeffrey Dharmawan (DENTIST) |
| Authorized Official Contact | 9098251155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 190 W H St Ste 100 Colton CA 92324-2937 Ph: (909) 825-1155 | None 190 W H St Suite 100 Colton CA 92324 Ph: (909) 825-1155 |
| NPI Number | 1528487634 |
|---|---|
| Provider Enumeration Date | 04/16/2014 |
| Last Update Date | 04/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528487634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 33276 (California) | Primary |
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