Childrens Dental Funzone | |
500 San Fernardo Mission Blvd Suite #2 San Fernardo CA 91340 | |
(626) 966-3033 | |
Not Available |
Full Name | Childrens Dental Funzone |
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Speciality | Dentist - Pediatric Dentistry |
Location | 500 San Fernardo Mission Blvd Suite #2, San Fernardo, California |
Authorized Official Name and Position | Fariborz Rodef (PRESIDENT) |
Authorized Official Contact | 6269663033 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Childrens Dental Funzone 2233 E. Garvey Ave N. West Covina CA 91791 Ph: (626) 966-3033 | Childrens Dental Funzone 500 San Fernardo Mission Blvd Suite #2 San Fernardo CA 91340 Ph: (626) 966-3033 |
NPI Number | 1235623190 |
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Provider Enumeration Date | 06/14/2018 |
Last Update Date | 06/14/2018 |
Identifier | Type | State | Issuer |
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1235623190 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 62906 (California) | Secondary |
1223P0221X | Dentist - Pediatric Dentistry | 38356 (California) | Primary |