| Golden West Dentistry | |
|
9922 Sierra Ave Fontana CA 92335-6721 | |
| (909) 822-4800 | |
| (909) 822-4899 |
| Full Name | Golden West Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9922 Sierra Ave, Fontana, California |
| Authorized Official Name and Position | Wilberto Isaac Penalba (OWNER/PRESIDENT) |
| Authorized Official Contact | 9516752690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden West Dentistry 281 Heron Ln Riverside CA 92507-1241 Ph: (951) 675-2690 | Golden West Dentistry 9922 Sierra Ave Fontana CA 92335-6721 Ph: (909) 822-4800 |
| NPI Number | 1811390578 |
|---|---|
| Provider Enumeration Date | 10/08/2014 |
| Last Update Date | 10/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811390578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 60504 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 60505 (California) | Secondary |
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