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11561 Foothill Blvd Suite 104 Rancho Cucamonga CA 91730-3997 | |
| (909) 483-7811 | |
| (909) 944-1742 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 11561 Foothill Blvd, Rancho Cucamonga, California |
| Authorized Official Name and Position | Shorouq Sahawneh (OWNER/DENTIST) |
| Authorized Official Contact | 7145786358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 Spectrum Center Dr Ste 100 Irvine CA 92618-4962 Ph: (714) 578-6358 | 11561 Foothill Blvd Suite 104 Rancho Cucamonga CA 91730-3997 Ph: (909) 483-7811 |
| NPI Number | 1942685581 |
|---|---|
| Provider Enumeration Date | 07/24/2015 |
| Last Update Date | 07/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942685581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 55643 (California) | Primary |
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Parisa Dental Group Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8599 Haven Ave Ste 105, Rancho Cucamonga, CA 91730 Phone: 909-945-2342 Fax: 909-948-5474 | |
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