| Hi-desert Oral & Maxillofacial Surgery Center | |
|
56669 29 Palms Hwy Suite A Yucca Valley CA 92284-5219 | |
| (760) 365-0658 | |
| (760) 365-5308 |
| Full Name | Hi-desert Oral & Maxillofacial Surgery Center |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 56669 29 Palms Hwy, Yucca Valley, California |
| Authorized Official Name and Position | Lonnie W Tiner (PRESIDENT OWNER) |
| Authorized Official Contact | 7603650658 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hi-desert Oral & Maxillofacial Surgery Center 56669 29 Palms Hwy Suite A Yucca Valley CA 92284-5219 Ph: (760) 365-0658 | Hi-desert Oral & Maxillofacial Surgery Center 56669 29 Palms Hwy Suite A Yucca Valley CA 92284-5219 Ph: (760) 365-0658 |
| NPI Number | 1265636112 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 07/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265636112 | NPI | - | NPPES |
| G9196501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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Phillip Sung W Cho Dental Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 56969 Yucca Trl Ste C, Yucca Valley, CA 92284 Phone: 760-228-1733 Fax: 760-365-9123 | |
Lombardo Cho Dental Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 56969 Yucca Trl Ste C, Yucca Valley, CA 92284 Phone: 760-228-1733 Fax: 760-365-9123 | |
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