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2836 W Rialto Ave Ste A Rialto CA 92376-6816 | |
| (909) 820-9454 | |
| (909) 820-9482 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2836 W Rialto Ave Ste A, Rialto, California |
| Authorized Official Name and Position | Henry S. Kwon (PROVIDER/PRESIDENT) |
| Authorized Official Contact | 9098209454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2836 W Rialto Ave Ste A Rialto CA 92376-6816 Ph: (909) 820-9454 | 2836 W Rialto Ave Ste A Rialto CA 92376-6816 Ph: (909) 820-9454 |
| NPI Number | 1558683649 |
|---|---|
| Provider Enumeration Date | 02/17/2010 |
| Last Update Date | 02/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558683649 | NPI | - | NPPES |
| B4750501 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D47505 (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 | |