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10431 Lemon Ave Suite K Rancho Cucamonga CA 91737-3700 | |
| (909) 476-8303 | |
| (909) 476-8206 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 10431 Lemon Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Tuan D Nguyen (OFFICER) |
| Authorized Official Contact | 9094768303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10431 Lemon Ave Suite K Rancho Cucamonga CA 91737-3700 Ph: (909) 476-8303 | 10431 Lemon Ave Suite K Rancho Cucamonga CA 91737-3700 Ph: (909) 476-8303 |
| NPI Number | 1841375904 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841375904 | NPI | - | NPPES |
| G91926-01 | Other | CA | DENTICAL PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 45512 (California) | Primary |
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