| Dental Corporation Of Wade Melvin Banner Dmd Inc | |
|
929 Foothill Blvd Ste B La Verne CA 91750-3223 | |
| (909) 973-0099 | |
| Not Available |
| Full Name | Dental Corporation Of Wade Melvin Banner Dmd Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 929 Foothill Blvd Ste B, La Verne, California |
| Authorized Official Name and Position | Wade Banner (OWNER) |
| Authorized Official Contact | 9099730099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Corporation Of Wade Melvin Banner Dmd Inc 929 Foothill Blvd Ste B La Verne CA 91750-3223 Ph: () - | Dental Corporation Of Wade Melvin Banner Dmd Inc 929 Foothill Blvd Ste B La Verne CA 91750-3223 Ph: (909) 973-0099 |
| NPI Number | 1669182333 |
|---|---|
| Provider Enumeration Date | 12/02/2022 |
| Last Update Date | 12/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669182333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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