| Persona Dental Group Of Shaw Dds, Inc. | |
|
8221 Rochester Ave Ste 110 Rancho Cucamonga CA 91730-0721 | |
| (310) 347-6172 | |
| Not Available |
| Full Name | Persona Dental Group Of Shaw Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8221 Rochester Ave Ste 110, Rancho Cucamonga, California |
| Authorized Official Name and Position | James Chung Shaw (OWNER) |
| Authorized Official Contact | 3103476172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Persona Dental Group Of Shaw Dds, Inc. 8221 Rochester Ave Ste 110 Rancho Cucamonga CA 91730-0721 Ph: (310) 347-6172 | Persona Dental Group Of Shaw Dds, Inc. 8221 Rochester Ave Ste 110 Rancho Cucamonga CA 91730-0721 Ph: (310) 347-6172 |
| NPI Number | 1184999815 |
|---|---|
| Provider Enumeration Date | 03/13/2012 |
| Last Update Date | 03/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184999815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 59455 (California) | Primary |
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