| Aspen Dental Group, Inc. | |
|
21007 Nemophilia St Suite B California City CA 93505-1963 | |
| (760) 373-1950 | |
| (760) 373-0072 |
| Full Name | Aspen Dental Group, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21007 Nemophilia St, California City, California |
| Authorized Official Name and Position | Glenn Lanzar Ong-veloso (OWNER) |
| Authorized Official Contact | 7603731950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Group, Inc. 21007 Nemophilia St Suite B California City CA 93505-1963 Ph: (760) 373-1950 | Aspen Dental Group, Inc. 21007 Nemophilia St Suite B California City CA 93505-1963 Ph: (760) 373-1950 |
| NPI Number | 1215080452 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215080452 | NPI | - | NPPES |
| B44316-1 | Other | CA | HEALTHY FAMILIES |
| G91712-02 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |