| Adrian Acosta Dds A Professional Dental Corp | |
|
11875 Pigeon Pass Road Suite B9 Moreno Valley CA 92557-6039 | |
| (951) 488-8688 | |
| (951) 488-8688 |
| Full Name | Adrian Acosta Dds A Professional Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11875 Pigeon Pass Road, Moreno Valley, California |
| Authorized Official Name and Position | Alan Boval (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5623560948 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adrian Acosta Dds A Professional Dental Corp 901 W. Whitter Blvd La Habra CA 90631-3743 Ph: (562) 356-0948 | Adrian Acosta Dds A Professional Dental Corp 11875 Pigeon Pass Road Suite B9 Moreno Valley CA 92557-6039 Ph: (951) 488-8688 |
| NPI Number | 1720694656 |
|---|---|
| Provider Enumeration Date | 09/16/2020 |
| Last Update Date | 09/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720694656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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