| Grovedental Group | |
|
8283 Grove Ave Suite 208 Rancho Cucamonga CA 91730-3137 | |
| (909) 291-8625 | |
| (909) 291-8629 |
| Full Name | Grovedental Group |
|---|---|
| Speciality | Dentist |
| Location | 8283 Grove Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Arsen Sukiasyan (PRESIDENT) |
| Authorized Official Contact | 9092918625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grovedental Group 8283 Grove Ave Suite 208 Rancho Cucamonga CA 91730-3137 Ph: (909) 291-8625 | Grovedental Group 8283 Grove Ave Suite 208 Rancho Cucamonga CA 91730-3137 Ph: (909) 291-8625 |
| NPI Number | 1124184825 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124184825 | NPI | - | NPPES |
| G92938 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49999 (California) | Primary |
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