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432 N Riverside Ave Rialto CA 92376-5012 | |
| (909) 874-2121 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 432 N Riverside Ave, Rialto, California |
| Authorized Official Name and Position | Pedro M Sandoval (PRESIDENT) |
| Authorized Official Contact | 9098739707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
432 N Riverside Ave Rialto CA 92376-5012 Ph: (909) 874-2121 | 432 N Riverside Ave Rialto CA 92376-5012 Ph: (909) 874-2121 |
| NPI Number | 1043590060 |
|---|---|
| Provider Enumeration Date | 08/22/2011 |
| Last Update Date | 04/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043590060 | NPI | - | NPPES |
| G8924701 | Other | CA | MEDI-CAL |
| 1194941245 | Other | CA | EIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49402 (California) | Primary |
Patricia Ann Pompa, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1723 N Riverside Ave, Rialto, CA 92376 Phone: 909-874-3210 Fax: 909-874-3802 | |
Western Dental Services, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 W. Foothill Blvd., Rialto, CA 92376 Phone: 909-546-1366 Fax: 909-820-7561 | |