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1074 W. Sixth Street Ste104 Corona CA 92882 | |
| (951) 279-7650 | |
| (951) 279-7650 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1074 W. Sixth Street, Corona, California |
| Authorized Official Name and Position | William J. Cox (PRESIDENT) |
| Authorized Official Contact | 8006846440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1101 Se Tech Center Drive Ste 195 Vancouver WA 98683-5511 Ph: (800) 684-6440 | 1074 W. Sixth Street Ste104 Corona CA 92882 Ph: (951) 279-7650 |
| NPI Number | 1255543807 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 01/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255543807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43359 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | 26160 (California) | Primary |
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