| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 930 Beaumont Ave, Beaumont, California |
| Authorized Official Name and Position | Stephanie Cervantes (REGIONAL MANAGER) |
| Authorized Official Contact | 7606179639 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
930 Beaumont Ave Beaumont CA 92223-1831 Ph: (951) 845-2200 | 930 Beaumont Ave Beaumont CA 92223 Ph: (951) 845-2200 |
| NPI Number | 1346767514 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346767514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Daniel C. Park Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 Beaumont Ave, Beaumont, CA 92223 Phone: 951-845-2661 Fax: 888-462-1262 | |
Nomi Lee Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Highland Springs Ave, Suite 11, Beaumont, CA 92223 Phone: 909-522-7815 | |