| Fresh Leaf Dental | |
|
815 W Holt Blvd Ste 402 Ontario CA 91762-3681 | |
| (972) 746-0881 | |
| Not Available |
| Full Name | Fresh Leaf Dental |
|---|---|
| Speciality | Dentist |
| Location | 815 W Holt Blvd Ste 402, Ontario, California |
| Authorized Official Name and Position | Nevein Amer (PRESIDENT/OWNER) |
| Authorized Official Contact | 9727460881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Leaf Dental 815 W Holt Blvd Ste 402 Ontario CA 91762-3681 Ph: (972) 746-0881 | Fresh Leaf Dental 815 W Holt Blvd Ste 402 Ontario CA 91762-3681 Ph: (972) 746-0881 |
| NPI Number | 1033592241 |
|---|---|
| Provider Enumeration Date | 07/07/2015 |
| Last Update Date | 12/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033592241 | NPI | - | NPPES |
| 47881 | Other | CA | DDS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 47881 (California) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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