| Russel R. Nolasco DDS, Inc | |
|
1042 N Mountain Ave Ste A2 Upland CA 91786-3695 | |
| (909) 579-0623 | |
| Not Available |
| Full Name | Russel R. Nolasco DDS, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1042 N Mountain Ave Ste A2, Upland, California |
| Authorized Official Name and Position | Russel Nolasco (PRESIDENT) |
| Authorized Official Contact | 7602016519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russel R. Nolasco DDS, Inc 1042 N Mountain Ave Ste A2 Upland CA 91786-3695 Ph: (909) 579-0623 | Russel R. Nolasco DDS, Inc 1042 N Mountain Ave Ste A2 Upland CA 91786-3695 Ph: (909) 579-0623 |
| NPI Number | 1053172106 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053172106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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