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1817 N Riverside Ave Rialto CA 92376-8069 | |
(909) 879-1024 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1817 N Riverside Ave, Rialto, California |
Authorized Official Name and Position | Carmy Gabriel Michael (CEO) |
Authorized Official Contact | 7148746069 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1817 N Riverside Ave Rialto CA 92376-8069 Ph: (909) 879-1024 | 1817 N Riverside Ave Rialto CA 92376-8069 Ph: (909) 879-1024 |
NPI Number | 1376021576 |
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Provider Enumeration Date | 07/31/2018 |
Last Update Date | 07/12/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376021576 | NPI | - | NPPES |
1730216599 | Medicaid | MI | |
12-4767679 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | 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 | |