| Dr. Roland Yakubov Professional Dental Inc | |
|
646 W Main St Ste A El Centro CA 92243-7914 | |
| (818) 726-8534 | |
| Not Available |
| Full Name | Dr. Roland Yakubov Professional Dental Inc |
|---|---|
| Speciality | Dentist |
| Location | 646 W Main St Ste A, El Centro, California |
| Authorized Official Name and Position | Roland Yakubov (PRESIDENT) |
| Authorized Official Contact | 8187268534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Roland Yakubov Professional Dental Inc 646 W Main St Ste A El Centro CA 92243-7914 Ph: (818) 726-8534 | Dr. Roland Yakubov Professional Dental Inc 646 W Main St Ste A El Centro CA 92243-7914 Ph: (818) 726-8534 |
| NPI Number | 1174913404 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 01/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174913404 | NPI | - | NPPES |
| 1235563396 | Medicaid | CA | |
| 1538490339 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 57064 (California) | Primary |
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