| Rancho Dental Office | |
|
2010 N Riverside Ave Suite A Rialto CA 92377-4652 | |
| (909) 421-1555 | |
| (909) 421-1865 |
| Full Name | Rancho Dental Office |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2010 N Riverside Ave, Rialto, California |
| Authorized Official Name and Position | Fernando J Villarroel (OWNER) |
| Authorized Official Contact | 9094211555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rancho Dental Office 2010 N Riverside Ave Suite A Rialto CA 92377-4652 Ph: (909) 421-1555 | Rancho Dental Office 2010 N Riverside Ave Suite A Rialto CA 92377-4652 Ph: (909) 421-1555 |
| NPI Number | 1750576096 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 09/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750576096 | NPI | - | NPPES |
| G93878-01 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 44377 (California) | Primary |
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