| Ethel Cruz Dmd Inc | |
|
5814 Riverside Drive Chino CA 91710 | |
| (909) 548-4844 | |
| (909) 548-0774 |
| Full Name | Ethel Cruz Dmd Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5814 Riverside Drive, Chino, California |
| Authorized Official Name and Position | Ethel S Cruz (OWNER) |
| Authorized Official Contact | 9095484844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethel Cruz Dmd Inc 5814 Riverside Drive Chino CA 91710 Ph: (909) 548-4844 | Ethel Cruz Dmd Inc 5814 Riverside Drive Chino CA 91710 Ph: (909) 548-4844 |
| NPI Number | 1295938447 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295938447 | NPI | - | NPPES |
| G9416101 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 51913 (California) | Primary |
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