| Heritage Dental Group | |
|
13677 Foothill Blvd Suite #l Fontana CA 92335-0214 | |
| (909) 899-8040 | |
| (909) 463-7424 |
| Full Name | Heritage Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 13677 Foothill Blvd, Fontana, California |
| Authorized Official Name and Position | Kunjal Patel (OWNER DENTIST) |
| Authorized Official Contact | 9098998040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Dental Group 13677 Foothill Blvd Suite #l Fontana CA 92335-0214 Ph: (909) 899-8040 | Heritage Dental Group 13677 Foothill Blvd Suite #l Fontana CA 92335-0214 Ph: (909) 899-8040 |
| NPI Number | 1700911922 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700911922 | NPI | - | NPPES |
| 511274 | Other | MEDI CAL CA STATE PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | B34037 (California) | Primary |
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