| Bravo Dental Group Of Corona | |
|
1185 Magnolia Ave #k Corona CA 92879-3218 | |
| (951) 898-9223 | |
| (951) 898-6985 |
| Full Name | Bravo Dental Group Of Corona |
|---|---|
| Speciality | Dentist |
| Location | 1185 Magnolia Ave, Corona, California |
| Authorized Official Name and Position | Ayed Hawatmeh (CEO) |
| Authorized Official Contact | 9518989223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bravo Dental Group Of Corona 1185 Magnolia Ave #k Corona CA 92879-3218 Ph: (951) 898-9223 | Bravo Dental Group Of Corona 1185 Magnolia Ave #k Corona CA 92879-3218 Ph: (951) 898-9223 |
| NPI Number | 1649704347 |
|---|---|
| Provider Enumeration Date | 04/19/2017 |
| Last Update Date | 12/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649704347 | NPI | - | NPPES |
| 1982000923 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49108 (California) | Primary |
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